As many of you are aware the American Academy of Pediatrics
Committee on Infectious Diseases has issued guidelines for RSV
immunoprophylaxis with palivizumab (Synagis) for 2009 that differ from
those issued in 2006.
The most significant changes apply to babies aged 32 to 35 weeks:
Only one of two risk factors need be present: child care attendance, siblings <5 yrs of age
The criteria for babies born less than 32 weeks gestation and for babies with congenital heart disease and bronchopulmonary dysplasia have not changed from 2006.
We would like to stress that these are guidelines only and that there may be individual situations where more doses are warranted, especially in this late preterm age group. In such situations the pediatrician may need to advocate payers to allow doses after 90 days for these infants born between 32 to 34+6 weeks.
We would like to continue to stress the importance of avoidance of crowds and high exposure situations as well as good handwashing in preventing RSV bronchiolotis.