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| |  Simple Tool Helps Identify Premature Babies Likely to Benefit From Palivizumab-Based Prophylaxis for Respiratory Syncytial Virus: Presented at PAS By Jill Stein BALTIMORE, Md -- May 4, 2009 -- A simple tool can help physicians decide which of their 33- to 35-week gestational age (GA) infants with a moderate to high risk of respiratory syncytial virus (RSV) infection should be targeted for palivizumab prophylaxis, according to research released here at the 2009 Pediatric Academic Societies (PAS) Annual Meeting. Bosco A. Paes, MD, McMaster University, Hamilton, Ontario, and colleagues tested the impact of a risk scoring tool as a strategy for targeting prophylaxis effectively in 33- to 35-week GA infants, who ranged from having a low to high risk of RSV infection. The primary endpoint was the incidence of RSV hospitalisation. Palivizumab prophylaxis against RSV has been widely adopted for high-risk infants during the RSV season based on the Canadian Paediatric Society and the National Advisory Committee on Immunization guidelines, Dr. Paes observed, speaking here at a presentation here on May 3. The risk scoring tool used in the trial was recently developed by the Paediatric Investigators Collaborative Network on Infections in Canada for precisely these patients, and includes 7 risk factors and cutoff scores of 0 to 48, 49 to 64, and 65 to 100 for low-, moderate-, and high-risk patients, respectively. The analysis included 430 moderate- and high-risk infants who received palivizumab at monthly intervals between November and April in the years 2005 through 2008 (during the RSV seasons). All parents were given information on RSV prophylaxis at the time of hospital discharge. They were contacted by telephone at the end of each RSV season, and medical records were examined to determine RSV hospitalisation. Of the 430 infants, 346 scored in the low-risk category, 57 in the moderate-risk category, and 27 in the high-risk category. Overall, 78 (18.1%) infants received full courses of palivizumab during the RSV seasons, with excellent compliance within the proper monthly injection-time intervals. Six (10.5%) of 57 infants in the moderate-risk group did not receive prophylaxis, while all 27 high-risk group infants received palivizumab. Seven (1.6%) infants were RSV-positive and 5 low-risk infants who did not receive prophylaxis were hospitalised. Dr. Paes said that the risk scoring tool is an efficient, cost-effective, practical technique that identified roughly 18% of infants out of a large birth cohort who would benefit most from RSV prophylaxis. In addition, the tool is user-friendly, and can be used in community settings. Finally, Dr. Paes noted that this tool can help facilitate clinical decisions, teach parents about the risk profiles of their children, and help them to plan appropriate RSV prevention strategies. To date, 7 Canadian provinces have adopted the risk-scoring tool in its current or modified format based on local Ministry of Health guidelines. [Presentation title: Does a Risk Scoring Tool Target RSV Prophylaxis Effectively in 33-35 Completed Weeks Gestational Age Infants? Abstract 3866.259]
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