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Respiratory Syncytial Virus Immune Globulin (RSVIG) was recently licensed for prevention of RSV disease in high-risk infants. RSVIG was given to children in an area served by a single Pediatric Intensive Care Unit (PICU) starting in 1996-97. During this RSV season, 56 infants in high risk categories for severe RSV disease (<1 year of age, <29 weeks gestation or <2 years of age with bronchopulmonary dysplasia, significant chronic lung disease or immunodeficiency) received RSVIG. This study was performed to evaluate the effects of community-wide RSVIG use on RSV-related admissions to the PICU. We reviewed the charts of all patients <3 years old who were admitted to the PICU with RSV infection during the 1994-95, 1995-96, and 1996-97 RSV seasons. Characteristics of patients admitted in 1996-97 (when RSVIG was used) were compared to those of patients in the previous two RSV seasons (when RSVIG was not used). Overall, 19% of patients admitted to the PICU for RSV infection filled our community criteria for RSVIG administration. Table
Total PICU days were significantly reduced concomittant with community-wide RSVIG prophylaxis, while trends toward reductions in ventilator days and mortality were observed. RSVIG prophylaxis of high-risk infants may reduce the burden of RSV disease among patients admitted to the PICU. However, since most patients admitted to the PICU for RSV disease do not fall into high-risk categories, more broadly-based prophylactic strategies are needed to further reduce the burden of severe RSV disease.
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