Palivizumab for respiratory syncytial virus prophylaxis.

Palivizumab, a humanized monoclonal antibody, has been approved by the FDA to prevent severe lower respiratory tract infections caused by RSV in high-risk patients. Prophylaxis of RSV infections with palivizumab requires monthly injections (15 mg/kg) during the RSV season. In the IMpact-RSV study, hospitalizations resulting from RSV decreased by 55% in the palivizumab treatment group. Palivizumab has also been shown to decrease the number of days with moderate or severe RSV infection, with an increased oxygen requirement, and ICU admissions. Palivizumab has been shown to be well tolerated with minimal adverse effects. The most frequently reported adverse effects were fever and minor injection site reactions. Determination of which patients should receive RSV prophylaxis should take into consideration all risk factors. Recommendations for RSV prophylaxis with RSV-IGIV and palivizumab have been published by the American Academy of Pediatrics. To date, no studies directly comparing RSV-IGIV and palivuzumab have been conducted. Neither product is recommended in children with congenital heart disease.