Clark S J, Beresford M W, Subhedar N V, Shaw N J
University of Liverpool, Liverpool, UK.
Arch Dis Child. 2000 Oct;83(4):313-6. doi: 10.1136/adc.83.4.313.
Bronchiolitis caused by respiratory syncytial virus (RSV) is an important cause of morbidity in ex-premature infants. In a randomised placebo controlled trial monoclonal antibody prophylaxis showed a 55% reduction in relative risk of hospital admission for these high risk infants, against a background incidence of 10.6 admissions per 100 high risk infants.
To follow a cohort of high risk infants in order to assess hospitalisation rate from RSV and the potential impact of prophylaxis for these patients in a UK local health authority.
A cohort of high risk infants from a local health authority were followed over the 1998/99 and 1999/2000 RSV seasons. The high risk population was defined as infants who, at the beginning of the seasons studied, were: (1) under 6 months old and born prior to 36 weeks gestation with no domiciliary oxygen requirement; or (2) under 24 months of age and discharged home in supplemental oxygen. All admissions with bronchiolitis during the season were identified.
A total of 370 high risk infants were identified for the 1998/99 season and 286 for the following year. Over the two years there were 68 admissions. Significantly more admissions occurred from group 2 infants. RSV was identified in 27 cases (four admissions per hundred high risk infants). Prophylaxis may have saved up to pound 195,134 in hospital costs over the two years, but would have cost pound 1.1 million in drug acquisition costs.
Careful consideration of risk factors is needed when selecting infants for RSV prophylaxis.
呼吸道合胞病毒（RSV）引起的细支气管炎是早产低体重儿发病的重要原因。在一项随机安慰剂对照试验中，单克隆抗体预防措施使这些高危婴儿的住院相对风险降低了55%，而高危婴儿的背景发病率为每100名中有10.6人入院。
对一组高危婴儿进行随访，以评估英国当地卫生部门中RSV导致的住院率以及预防措施对这些患者的潜在影响。
对当地卫生部门的一组高危婴儿在1998/99和1999/2000年RSV流行季节进行随访。高危人群定义为在研究季节开始时：（1）年龄小于6个月且孕36周前出生且无需家庭吸氧；或（2）年龄小于24个月且出院时仍需补充氧气。确定该季节所有因细支气管炎入院的病例。
1998/99季节共确定370名高危婴儿，次年为286名。两年间共有68例入院病例。第2组婴儿的入院病例明显更多。27例病例检测出RSV（每100名高危婴儿中有4例入院）。预防措施在两年内可能节省高达195,134英镑的住院费用，但药物购置成本将达110万英镑。
在选择进行RSV预防的婴儿时，需要仔细考虑风险因素。
