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Paediatr Respir Rev. 2018 Dec 18. pii: S1526-0542(18)30139-8. doi: 10.1016/j.prrv.2018.12.001. [Epub ahead of print]

Expert consensus on palivizumab use for respiratory syncytial virus in developed countries.

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Complutense University, Research Institute University Hospital Gregorio Marañon. Neonatology Division, Avda. de Séneca 2, 28040 Madrid, Spain.
Neonatology and NICU, S.Anna Hospital, AOU Città della Salute e della Scienza, Corso Spezia 60, 10126 Torino, Italy; Respiratory Syncytial Virus Network (ReSViNET), Italy.
Department of Pediatrics (Neonatal Division), McMaster University, 1280 Main St W, Hamilton, ON L8S 4L8, Canada.
Women's and Children's Health Department, University of Padova, Via 8 Febbraio 1848, 35122 Padova, Italy; Respiratory Syncytial Virus Network (ReSViNET), Italy.
Neonatal Intensive Care Unit, University Hospitals Leuven, Department of Development and Regeneration, KU Leuven, Oude Markt 13, 3000 Leuven, Belgium.
Neonatal Department, Rambam Health Care Campus, Rappaport Faculty of Medicine, Technion, Efron St 1, Haifa, Israel.
Department of Pediatrics, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, Alberta T3B 6A8, Canada.
Division of Newborn Medicine, Bambino Gesù Children's Hospital and Research Institute, Piazza di Sant'Onofrio 4, 00165 Rome, Italy.
Department of Paediatrics, Hospital General Universitario Gregorio Marañón, Calle del Dr. Esquerdo 46, 28007 Madrid, Spain.
Division of Neonatology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerpl. 2, 8036 Graz, Austria.
Neonatology Service, Hospital Clinic, Institut d'Investigacions Biomediques August Pi Suñer (IDIBAPS), Carrer del Rosselló 149, 08036 Barcelona, Spain. Electronic address:


Respiratory syncytial virus (RSV) infection is a leading cause of hospitalisation in early childhood and palivizumab is the only licensed intervention for prevention. Palivizumab guidelines should reflect the latest evidence, in addition to cost-effectiveness and healthcare budgetary considerations. RSV experts from Europe, Canada and Israel undertook a systematic review of the evidence over the last 5 years and developed recommendations regarding prophylaxis in industrialised countries. Almost 400 publications were reviewed. This group recommended palivizumab for: preterm infants (<29 and ≤31 weeks gestational age [wGA] and ≤9 and ≤6 months of age, respectively; high-risk 32-35wGA), former preterm children ≤24 months with chronic lung disease/bronchopulmonary dysplasia, children ≤24 months with significant congenital heart disease; and other high-risk populations, such as children ≤24 months with Down syndrome, pulmonary/neuromuscular disorders, immunocompromised, and cystic fibrosis. Up to 5 monthly doses should be administered over the RSV season. It is our impression that the adoption of these guidelines would help reduce the burden of RSV.


Evidence-based medicine; Lower respiratory tract infection; Neonatal lung disease; Palivizumab; Respiratory syncytial virus


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