New AAP Guidelines for Treating RSV
For the second time in two years, the American Academy of Pediatrics is calling for doctors to scale back the use of palivizumab prophylaxis when it comes to treating RSV in infants.
Respiratory syncytial virus, or RSV, is a common lung infection that most kids come into contact with by age two. It’s usually nothing too serious; inflammation in the lungs causes a wheezing sound and results in other cold symptoms like a runny nose, cough or fever. However, RSV is also the leading culprit behind pneumonia, and up to 125,000 infants are hospitalized with it each year.
Because RSV is rarely serious, and because neonatal care has improved leaps and bounds, the AAP is narrowing its guidelines for the use of the drug palivizumab, sold under the brand name Synagis by MedImmune. Plus, research shows that only very young preemies benefit from the drugs. So the scope of the new guidelines is essentially limited to them: “palivizumab prophylaxis [should] be limited to infants born before 29 weeks gestation, and to infants with certain chronic illnesses like congenital heart disease or chronic lung disease.”
This is change from the previous guidelines — in place since 1998 — which recommended the drug for preemies up to 35 weeks. Studies show that palivizumab, which is administered in seasonal injections, can slightly reduce the risk of RSV hospitalization in “high risk” or premature infants. But it doesn’t reduce the duration of hospital visits that do occur, or the risk of long-term complications. Still, spokesperson Alisha Martin says parent company MedImmune placed full-page ads in The New York Times challenging the AAP because they “felt it important to inform parents – including the half-a-million women who give birth prematurely each year – of the decisions being made that could impact the lives of their children.”
But for those older premature children without chronic illnesses, the AAP recommends less drastic measures like “offering breast milk, immunizing members of the household against influenza, practicing good hand and cough hygiene, avoiding smoke exposure, limiting attendance in large group child care during the first winter season whenever possible, and avoiding contact with anyone who is ill.”
Has your child contracted a serious bout of RSV?
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