Prophylaxis against respiratory syncytial virus in young children with cystic fibrosis

Abstract

Introduction In cystic fibrosis (CF) patients, respiratory syncytial virus (RSV) infection is associated with significant morbidity. Although passive prophylaxis with palivizumab lowers hospitalization rate for RSV infection in populations at risk of severe infection, its use is not recommended in infants with CF disease. Objective To determine the effect of palivizumab prophylaxis on hospitalization for acute respiratory illness in young children with CF during the first RSV season following the diagnosis of CF. Methods In this retrospective study, medical records of patients diagnosed with CF between the years 1997 and 2005 inclusively and on whom the diagnosis was made before 18 months of age were reviewed. Collected data included age at diagnosis, palivizumab prophylaxis, occurrence of hospitalization for acute respiratory tract illness during the RSV season and identification of RSV infection. Results A diagnosis of CF was made in 76 young children and data collected from 75 children. Of those, 40 did not receive RSV prophylaxis while 35 received palivizumab injection monthly during the RSV season. Among non-recipient children, 7 out of 40 were hospitalized for acute respiratory illness during the RSV season. Of these seven patients, RSV detection was positive in nasopharyngeal secretions in three patients, negative in one patient and not requested in the others. Among palivizumab recipients, 3 out of 35 children were hospitalized for acute respiratory illness (P > 0.05 compared to non-recipients group). In these three palivizumab recipients, RSV detection was negative in nasopharyngeal secretions. Palivizumab recipients experienced fewer hospital days per patient for acute respiratory illness (mean ± SD: 0.8 ± 3.07 days) as compared to non-recipients (mean ± SD: 1.73 ± 4.27 days) but this difference did not reach statistical significance. Conclusion CF infants may benefit from RSV immunoprophylaxis with palivizumab. Pediatr Pulmonol. 2008; 43:169–174.