Abstract

Objectives This is a report of pediatric patients hospitalized with Respiratory Syncytial Virus Infection (RSV) during the season prior to, and 2 seasons following the 2014 palivizumab prophylaxis guidance release. The primary aim was to determine the effect of the 2014 guidance on children no longer considered eligible for prophylaxis. Secondary aims were to 1) Describe and compare morbidity among all children hospitalized with RSV following the 2014 guidance, 2) Assess adherence to the updated guidance, and 3) Assess associated drug cost savings. Study design We performed a retrospective chart review of pediatric patients admitted for RSV disease at our institution during the RSV season from October 2013 - March 2016. Patients who met prior palivizumab qualifications, but were excluded according to 2014 guidance were compared pre and post adoption of 2014 palivizumab guidance. Neonatal Intensive Care Unit (NICU) records were assessed for adherence to 2014 guidance and resulting palivizumab drug cost was compared. Results Among cases qualifying according to previous guidance, but excluded in the 2014 update, there were no significant differences seen in the rate of RSV hospitalization, admission to higher level of care, increased respiratory support requirement, or length of stay. Following the adoption of 2014 guidance, palivizumab dosing was reduced by 58%; the rate of appropriate prophylaxis among NICUs was 91%. This reduction resulted in an annual drug cost savings of $225,000. Conclusion Adoption of updated 2014 guidance at our institutions had little impact on hospitalization with RSV disease, while allowing for better resource management.

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