RSV prophylaxis with Palivizumab in high-risk children - Updated German national guidelines 2008

The humanized monoclonal antibody Palivizumab has been approved since 1999 for prophylactic use against RSV (respiratory syncytial virus) infection in premature infants (a parts per thousand currency sign35 gestational week) for the first and the second years of life in infants requiring treatment for bronchopulmonary dysplasia, as well as infants affected by congenital heart disease. The need for such prophylaxis is established on the basis that RSV is the most common cause of lower airway complications in the first two years of life. However, preventive administration of Palivizumab to all children for whom there is an indication according to licensure entails significant costs. Based on new clinical and epidemiological data, the German guidelines on RSV prophylaxis of 2006 have been updated. According to the new guidelines, high-risk children e. g. children with chronic lung diseases, requiring oxygen therapy, should receive - and medium-risk children e. g. preterm infants born at a parts per thousand currency sign28 weeks of gestational age or presenting additional risk factors can receive - prophylaxis. Decisions to use the prophylaxis will be made on the basis of establishing the risk of complicated RSV infection in individual patients. Furthermore it is stressed that high-risk children should be breast-fed, kept away from cigarette smoke, large groups of people and nursery schools, and should receive the generally recommended active immunizations, including vaccination against influenza, as soon as possible.