title: Practice points - Neonatal Intensive Care Drug Manual
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  Neonatal Intensive Care Drug Manual
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  bet | 416/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
  Practice points
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  Palivizumab for prevention of respiratory syncytial virus infection in children: Palivizumab prophylaxis is effective in reducing the frequency of hospitalisations including admissions to ICU due to RSV infection in children with chronic lung disease, congenital heart disease, or those born preterm. There is insufficient data to determine if Palivizumab prophylaxis reduces need for mechanical ventilation or mortality. [2] [LOE I GOR B]
  It is reasonable to consider use in Australia of palivizumab 15 mg/kg/dose from April to August (5 doses) in the following infants:
  Ex-preterm infants with chronic lung disease (oxygen or respiratory support at 36 weeks post menstrual age);
  Preterm infants born ≤26 weeks gestation;
  Infants with haemodynamically significant congenital heart disease between 0 to <6 months age; and
  Infants at risk of severe RSV bronchiolitis including infants with moderate to severe pulmonary conditions particularly those requiring continued respiratory and/or oxygen support.
  Children with severe pulmonary abnormality or neuromuscular disease that impairs the ability to clear secretions from the upper airways may be considered for prophylaxis in the first year of life.
  Children younger than 24 months who will be profoundly immunocompromised during the RSV season may be considered for prophylaxis.
  Insufficient data are available to recommend palivizumab prophylaxis for children with cystic fibrosis or Down syndrome.
  Additional practice points:
  Infants born during the RSV season may require fewer doses. [10, 12]
  Prophylaxis should be discontinued in any child who experiences a breakthrough RSV hospitalization. [10, 12]
  Prophylaxis is not required in congenital heart disease where there is mild cardiomyopathy or surgically corrected disease (unless medication required for heart failure). [3]
  After cardiopulmonary bypass surgery, give a dose once child is stable (serum concentration markedly reduced after these procedures); resume doses each month if prophylaxis still required. [3]
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