Should the American Academy of Pediatrics Respiratory Syncytial Virus Guidelines Be Modified?

PEDIATRICS ◽  
2010 ◽  
Vol 125 (4) ◽  
pp. e1021-e1021 ◽  
Author(s):  
G. A. Rossi ◽  
M. Silvestri ◽  
M. Lanari
Keyword(s):  
Respiratory Syncytial Virus ◽  
American Academy ◽  
American Academy Of Pediatrics ◽  
Syncytial Virus

scholarly journals Respiratory Syncytial Virus Hospitalizations among U.S. Preterm Infants Compared with Term Infants Before and After the 2014 American Academy of Pediatrics Guidance on Immunoprophylaxis: 2012–2016

2018 ◽  
Vol 35 (14) ◽  
pp. 1433-1442 ◽  
Author(s):  
Mitchell Goldstein ◽  
Leonard Krilov ◽  
Jaime Fergie ◽  
Kimmie McLaurin ◽  
Sally Wade ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
American Academy ◽  
Preterm Infants ◽  
Term Infants ◽  
American Academy Of Pediatrics ◽  
Before And After ◽  
Syncytial Virus ◽  
Using Data ◽  
Rate Ratios ◽  
Calculated Difference

Objective The objective of this study was to compare risk for respiratory syncytial virus (RSV) hospitalizations (RSVH) for preterm infants 29 to 34 weeks gestational age (wGA) versus term infants before and after 2014 guidance changes for immunoprophylaxis (IP), using data from the 2012 to 2016 RSV seasons. Study Design Using commercial and Medicaid claims databases, infants born between July 1, 2011 and June 30, 2016 were categorized as preterm or term. RSVH during the RSV season (November–March) were identified for infants aged <6 months and rate ratios (RRs) for hospitalization comparing preterm and term infants were calculated. Difference-in-difference models were fit to evaluate the changes in hospitalization risks in preterm versus term infants from 2012 to 2014 seasons to 2014 to 2016 seasons. Results In all seasons, preterm infants had higher RSVH rates than term infants. Seasonal RRs prior to the guidance change for preterm wGA categories versus term infants ranged from 1.6 to 3.4. After the guidance change, the seasonal RRs ranged from 2.6 to 5.6. In 2014 to 2016, the risk associated with prematurity of 29 to 34 wGA versus term was significantly higher than in 2012 to 2014 (P<0.0001 for commercial and Medicaid samples). Conclusion In infants aged <6 months, the risk for RSVH for infants 29 to 34 wGA compared with term infants increased significantly after the RSV IP recommendations became more restrictive.

scholarly journals Impact of the 2014 American Academy of Pediatrics Immunoprophylaxis Policy on the Rate, Severity, and Cost of Respiratory Syncytial Virus Hospitalizations among Preterm Infants

2019 ◽  
Vol 37 (02) ◽  
pp. 174-183 ◽  
Author(s):  
Leonard R. Krilov ◽  
Jaime Fergie ◽  
Mitchell Goldstein ◽  
Lance Brannman
Keyword(s):  
Respiratory Syncytial Virus ◽  
American Academy ◽  
Preterm Infants ◽  
Policy Change ◽  
Temporal Trends ◽  
Patient Characteristics ◽  
Administrative Claims ◽  
Term Infants ◽  
American Academy Of Pediatrics ◽  
Syncytial Virus

Objective This study examined the rate, severity, and cost of respiratory syncytial virus (RSV) hospitalizations among preterm infants 29 to 34 weeks gestational age (wGA) versus term infants before and after a 2014 change in the American Academy of Pediatrics policy for RSV immunoprophylaxis. Study Design Preterm (29–34 wGA) and term infants born from July 2011 to March 2017 and aged < 6 months were identified in a U.S. commercial administrative claims database. RSV hospitalization (RSVH) rate ratios, severity, and costs were evaluated for the 2011 to 2014 and 2014 to 2017 RSV seasons. Postpolicy changes in RSVH risks for preterm versus term infants were assessed with difference-in-difference (DID) modeling to control for patient characteristics and temporal trends. Results In the DID analysis, prematurity-associated RSVH risk was 55% greater in 2014 to 2017 versus 2011 to 2014 (relative risk = 1.55, 95% confidence interval: 1.10–2.17, p = 0.011). RSVH severity increased among preterm infants after 2014 and was highest among those aged < 3 months. Differences in mean RSVH costs for preterm infants in 2014 to 2017 versus 2011 to 2014 were not statistically significant. Conclusion RSVH risk for preterm versus term infants increased after the policy change, confirming previous national analyses. RSVHs after the policy change were more severe, particularly among younger preterm infants.

Concerned About Ribavirin Recommendations

PEDIATRICS ◽  
1994 ◽  
Vol 94 (1) ◽  
pp. 132-133
Author(s):  
John F. Pope ◽  
James B. Besunder ◽  
Mary L. Kumar ◽  
Dennis M. Super
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Syncytial Virus ◽  
Infectious Diseases ◽  
American Academy ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
American Academy Of Pediatrics ◽  
Syncytial Virus ◽  
New Guidelines ◽  
Ventilated Patients

The Committee on Infectious Diseases of the American Academy of Pediatrics recently published new guidelines for using ribavirin in treating respiratory syncytial virus (RSV).1 In updating previous guidelines, the Committee, based on the study by Smith et al,2 added the recommendation that all RSV-infected patients who require mechanical ventilation should receive ribavirin. We believe the Committee's broad recommendation for using this drug in mechanically ventilated patients is premature. We have concerns about the Smith study that call into question their conclusions regarding the efficacy of ribavirin in mechanically ventilated children.

Letter to the Editor

PEDIATRICS ◽  
1994 ◽  
Vol 93 (5) ◽  
pp. 873-874
Author(s):  
Melvin I. Marks ◽  
Caroline B. Hall
Keyword(s):  
Respiratory Syncytial Virus ◽  
Infectious Diseases ◽  
American Academy ◽  
Mortality Rates ◽  
Double Blind ◽  
End Points ◽  
American Academy Of Pediatrics ◽  
Letter To The Editor ◽  
Syncytial Virus

Dr Zucker's letter describes concern about the American Academy of Pediatrics (AAP) Committee on Infectious Diseases statement on the use of ribavirin for the treatment of respiratory syncytial virus (RSV) infections (Pediatrics 1993;92:501-504). The Committee developed its recommendations on the basis of the available placebo-controlled prospective double-blind studies. Although these studies contained relatively small numbers of patients, they were controlled and prospective, and all showed a favorable response. The variable course of RSV illnesses and the relatively low mortality rates make clinically meaningful end-points difficult to define and quantitate.

Use of palivizumab in neonates who do not meet the American Academy of Pediatrics Guidelines for respiratory syncytial virus prophylaxis

2009 ◽  
Vol 85 (10) ◽  
pp. S93 ◽  
Author(s):  
Paolo Manzoni ◽  
MariaLisa Leonessa ◽  
Paolo Galletto ◽  
Elena Gallo ◽  
Ugo Sala ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
American Academy ◽  
American Academy Of Pediatrics ◽  
Syncytial Virus
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