INDIANAPOLIS — Providing the monoclonal antibody, palivizumab, during well baby visits improves the prevention of respiratory syncytial virus in high-risk urban infants, Dr. Hari B. Srinivasan said in a poster session at the annual meeting of the Midwest Society for Pediatric Research.
This approach eliminates having to arrange and pay for a separate home health visit, said Dr. Srinivasan of Sinai Children's Hospital in Chicago. In an urban inner-city population, home health visits to administer the monthly injections are complicated by the fact that many families either do not have a phone or frequently change their residence. And in some cases, there is significant delay involved in getting authorization from Medicaid health maintenance organizations to provide home visits, he said.
To prove the efficacy of this approach, the researchers reviewed the number of doses of palivizumab administered and the incidence and number of hospitalizations for RSV-related illness in a cohort of infants during the RSV season from November 2004 to April 2005.
All infants discharged from the neonatal intensive care unit were followed up in a high-risk clinic offering comprehensive medical care, including health maintenance visits.
Palivizumab (15 mg/kg) was given as monthly injections to infants qualifying under the American Academy of Pediatrics guidelines. Neonates discharged during the RSV season received their first injection prior to discharge from the neonatal intensive care unit.
A total of 72 infants qualified for palivizumab administration. The mean birth weight was 1,620 grams and the mean gestational age was 31 weeks.
Sixty-four percent of infants got all the recommended doses and 28% got 80% of the recommended doses, he said, adding that only 8% of the patients received fewer than 80% of the recommended doses.
During the study there were two documented RSV infections and one of the infants was hospitalized.
“This model of administration of palivizumab resulted in 91% of infants receiving greater than 80% of the recommended doses … and is a viable alternate to the home health model to administer palivizumab in an inner city population,” the researchers concluded.
Ninety-one percent of infants received greater than 80% of the recommended doses. DR. SRINIVASAN