Palivizumab prophylaxis and accordance in premature infants: our 9-years of experience

Objective: The aim of this study is to investigate whether patients under 2 years of age who have received RSV prophylaxis indication are hospitalized due to RSV-related acute lower respiratory tract infection (ALRI) during the RSV season, the length of hospital stay, the need for intensive care, the need for and duration of mechanical ventilation, and compliance with palivizumab prophylaxis. Method: Data from 618 patients under 2 years of age who received RSV prophylaxis indication at the Dicle University Faculty of Medicine Neonatal Polyclinic between October 1, 2014, and March 31, 2023, were retrospectively analyzed based on ward records. Demographic characteristics of the patients, duration of receiving mechanical ventilation (MV), continuous positive airway pressure (CPAP), and oxygenation support (KiO2), dosage and indication of palivizumab received, and surfactant administration were investigated. Results: A total of 618 patients were included in the study, comprising 308 females (49.8%) and 310 males (50.2%). It was found that 95.8% of the cases were born via cesarean section and 4.2% via normal delivery. Birth weeks were determined to be below 28 weeks in 60.5% of cases and between 28 and 32 weeks in 39.5% of cases. Birth weights were found to be below 1000 grams in 51.5% of cases, between 1000 and 1500 grams in 44%, and above 1500 grams in 4.5%. Diagnosis of bronchopulmonary dysplasia (BPD) was present in 57.1% of cases, and 89.5% received surfactant. It was determined that 57.1% received steroids. Among the cases, 50.6% received invasive MV, 88.2% received CPAP, and 81.1% received KiO2 support. The mean duration of receiving invasive MV was 3.89 ± 6.88 days for cases receiving invasive MV support, 11.05 ± 10.99 days for cases receiving CPAP support, and 16.86 ± 14.81 days for cases receiving KiO2 support. It was found that 42.6% of cases were diagnosed with prematurity, and 57.4% with prematurity + BPD. Regarding palivizumab dosage, 42.6% of cases were compliant with prophylaxis, while 57.4% were non-compliant. Conclusion: Our study demonstrates that timely and appropriate dosage of palivizumab prophylaxis in high-risk infants reduces the severity of RSV infection and decreases the need for intensive care. Therefore, full compliance with the palivizumab prophylaxis program is of utmost importance.