J Pediatr Infect Dis 2024; 19(06): 327-333
DOI: 10.1055/s-0044-1789266
Original Article

Effect of Palivizumab Prophylaxis on Respiratory Syncytial Virus Hospitalizations in Preterm Infants Born to 290/7 to 316/7 Weeks of Gestational Age

Elifcan Zamur
1   Department of Pediatrics, Izmir Tepecik Training and Research Hospital, İzmir, Türkiye
,
Ozgun Uygur
2   Division of Neonatology, Department of Pediatrics, Izmir Tepecik Training and Research Hospital, İzmir, Türkiye
,
Eda Karadag-Oncel
3   Division of Pediatric Infectious Diseases, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, İzmir, Türkiye
,
Sezgin Gunes
4   Division of Neonatology, Department of Pediatrics, Izmir Buca Seyfi Demirsoy Training and Research Hospital, İzmir, Türkiye
,
Suzan Sahin
5   Division of Neonatology, Department of Pediatrics, Izmir Demokrasi University Faculty of Medicine, İzmir, Türkiye
,
Melike Kefeli Demirel
2   Division of Neonatology, Department of Pediatrics, Izmir Tepecik Training and Research Hospital, İzmir, Türkiye
,
Defne Engur
2   Division of Neonatology, Department of Pediatrics, Izmir Tepecik Training and Research Hospital, İzmir, Türkiye
,
6   Division of Neonatology, Department of Pediatrics, Izmir Katip Çelebi University Faculty of Medicine, İzmir, Türkiye
› Author Affiliations
Funding The authors declare the study received no funding.

Abstract

Objective In 2020, in-line with the recommendations of the Turkish Neonatal Society, a new palivizumab indication was added for preterm infants with 290/7 to 316/7 weeks of gestational age. This study aimed to determine the risk factors of hospitalizations due to lower respiratory tract infections (LRTIs) and respiratory syncytial virus (RSV) in preterm infants (290/7–316/7 weeks of gestational age) who were or were not within the scope of palivizumab indication during the first two RSV seasons (2018–2019 and 2019–2020) and the next two RSV seasons (2020–2021 and 2021–2022) to evaluate the validity of the new indication of palivizumab reimbursement scope.

Methods This study was a two-center retrospective and prospective cohort study and included all preterm infants (290/7–316/7 weeks) aged 90 days and younger during the RSV season (October–March). The primary outcome was to compare the hospitalization rates between patients who received palivizumab and those who did not. The secondary outcome was to identify the risk factors for patients hospitalized due to LRTIs.

Results Of the 122 preterm infants included in the study, 48.3% (n = 59) were in the prophylaxis group (Group 1) and 51.7% (n = 63) were in the non-prophylaxis group (Group 2). It was noteworthy that 53.8% (n = 14) of the 26 infants hospitalized due to LRTIs were in Group 1 and 46.2% (n = 12) were in Group 2 (p = 0.682). Of the RSV PCR-positive infants, 62.5%(n = 5) were in Group 1 and 37.5% (n = 3) were in Group 2 (p = 0.30). The median length of hospitalization was similar in the groups (p = 0.123).

Conclusion The indication for palivizumab prophylaxis can be determined more clearly for our country in light of national multicenter studies with an increased sample size.



Publication History

Received: 31 January 2024

Accepted: 05 August 2024

Article published online:
22 August 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Alan S, Erdeve O, Cakir U. et al; TurkNICU-RSV Trial Group. Outcome of the Respiratory Syncytial Virus related acute lower respiratory tract infection among hospitalized newborns: a prospective multicenter study. J Matern Fetal Neonatal Med 2016; 29 (13) 2186-2193
  • 2 Hacımustafaoğlu M, Çelebi S, Bozdemir SE. et al. RSV frequency in children below 2 years hospitalized for lower respiratory tract infections. Turk J Pediatr 2013; 55 (02) 130-139
  • 3 Aujard Y, Fauroux B. Risk factors for severe respiratory syncytial virus infection in infants. Respir Med 2002; 96 (Suppl B): S9-S14
  • 4 Yalaz M, Kültürsay N. Respiratuvar sinsisyal virus enfeksiyonu ve riskli bebeklerde palivizumab profilaksisi. Çocuk Sağlığı ve Hastalıkları Dergisi 2014; 57: 200-213
  • 5 Johnson S, Oliver C, Prince GA. et al. Development of a humanized monoclonal antibody (MEDI-493) with potent in vitro and in vivo activity against respiratory syncytial virus. J Infect Dis 1997; 176 (05) 1215-1224
  • 6 Santos da Silva GN, Monti Atik D, Antunes Fernandes JL. et al. Synthesis of three triterpene series and their activity against respiratory syncytial virus. Arch Pharm (Weinheim) 2018; e1800108
  • 7 Connor EM. Palivizumab, a humanized respiratory syncytial virus monoclonal antibody, reduces hospitalization from respiratory syncytial virus infection in high-risk infants. The IMpact-RSV Study Group. Pediatrics 1998; 102 (3 Pt 1): 531-537
  • 8 Parnes C, Guillermin J, Habersang R. et al; Palivizumab Outcomes Registry Study Group. Palivizumab prophylaxis of respiratory syncytial virus disease in 2000-2001: results from The Palivizumab Outcomes Registry. Pediatr Pulmonol 2003; 35 (06) 484-489
  • 9 Paes B, Mitchell I, Li A, Harimoto T, Lanctôt KL. Respiratory-related hospitalizations following prophylaxis in the Canadian registry for palivizumab (2005-2012) compared to other international registries. Clin Dev Immunol 2013; 2013: 917068
  • 10 Oncel MY, Arayici S, Simsek GK. et al. Risk factors for hospitalization due to lower respiratory tract infection in preterm infants on palivizumab prophylaxis. Iran J Pediatr 2013; 23 (06) 693-700
  • 11 Ozkan H, Celebi S, Koksal N. et al; Turkish Neonatal Society RSV Study Group. Risk factors for respiratory syncytial virus infections in moderate/late premature infants in Turkey: a prospective multicenter epidemiological study. Am J Perinatol 2021; 38 (14) 1540-1546
  • 12 Acunaş B, Uslu S, Baş AY. Turkish Neonatal Society guideline for the follow-up of high-risk newborn infants. Turk Pediatri Ars 2018; 53 (Suppl 1): 180-195
  • 13 Shi T, Balsells E, Wastnedge E. et al. Risk factors for respiratory syncytial virus associated with acute lower respiratory infection in children under five years: systematic review and meta-analysis. J Glob Health 2015; 5 (02) 020416
  • 14 Figueras-Aloy J, Manzoni P, Paes B. et al. Defining the risk and associated morbidity and mortality of severe respiratory syncytial virus infection among preterm infants without chronic lung disease or congenital heart disease. Infect Dis Ther 2016; 5 (04) 417-452
  • 15 Hall CB, Weinberg GA, Blumkin AK. et al. Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age. Pediatrics 2013; 132 (02) e341-e348
  • 16 Oncel MY, Mutlu B, Kavurt S. et al. Respiratory syncytial virus prophylaxis in preterm infants: a cost-effectiveness study from Turkey. Turk J Pediatr 2012; 54 (04) 344-351
  • 17 Cetinkaya M, Oral TK, Karatekin S, Cebeci B, Babayigit A, Yesil Y. Efficacy of palivizumab prophylaxis on the frequency of RSV-associated lower respiratory tract infections in preterm infants: determination of the ideal target population for prophylaxis. Eur J Clin Microbiol Infect Dis 2017; 36 (09) 1629-1634