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Research Letter
February 2016

Outcomes of Respiratory Syncytial Virus Immunoprophylaxis in Infants Using an Abbreviated Dosing Regimen of Palivizumab

Author Affiliations
  • 1Children’s & Women’s Health Centre of British Columbia, University of British Columbia, Vancouver
  • 2Child & Family Research Institute, Vancouver, British Columbia
  • 3Division of Neonatology, Department of Pediatrics, University of British Columbia, Vancouver
  • 4Department of Pediatrics, University of Victoria, Victoria, British Columbia
  • 5Department of Pharmacy, University of British Columbia, Vancouver
  • 6Division of Allergy and Clinical Immunology, University of British Columbia, Vancouver
  • 7Canadian Center for Vaccinology, Halifax, Nova Scotia
  • 8Sidra Medical and Research Center, Doha, Qatar
JAMA Pediatr. 2016;170(2):174-176. doi:10.1001/jamapediatrics.2015.3235

Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infections in infants younger than 1 year. Premature infants, infants with chronic lung disease, infants with major congenital heart diseases, or infants with severe immunodeficiencies are at highest risk of hospital admission for RSV. Palivizumab, a monoclonal antibody, reduces pulmonary viral replication by 100-fold at serum drug levels greater than 40 μg/mL in the cotton rat model.1 On the basis of randomized clinical trials, monthly administration of 15 mg/kg of palivizumab reduces hospitalizations by approximately 55% in these infants.2 However, the costliness of this drug restrains its broader use. The American Academy of Pediatrics recommends a maximum of 5 palivizumab doses in selected risk groups during the RSV season,2 although pharmacokinetic analyses suggest that equivalent antibody protection may be sustainably achieved with fewer doses.3,4

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