PEDIATRICS Vol. 95 No. 4 April 1995, pp. 463-467
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Respiratory Syncytial Virus (RSV) Infection in Preterm Infants and the Protective Effects of RSV Immune Globulin (RSVIG)

Jessie R. Groothuis MD1, Eric A.F. Simoes MD1, Val G. Hemming MD2, and Respiratory Syncytial Virus Immune Globulin Study Group

1 Department of Pediatrics, Division of Neonatology and Infectious Diseases, University of Colorado School of Medicine, Denver, CO
2 Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD

Objective. To evaluate the safety and efficacy of respiratory syncytial virus immune globulin (RSVIG) in the prevention of severe respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) in infants born prematurely with or without bronchopulmonary dysplasia (BPD).

Methods. Data from a prospective, blinded, randomized, multicenter trial during three consecutive RSV seasons involving 249 children. This analysis comprises 162 preterm children, of whom 102 had BPD. The 87 children with congenital heart disease (CHD) were excluded from this analysis. Children were randomized to receive monthly infusions of RSVIG 750 mg/kg (high dose), RSVIG 150 mg/kg (low dose), or no RSVIG. Results from the preterm infants with and without BPD who received RSVIG 750 mg/kg are contrasted with control infants who did not receive RSVIG.

Results. As compared with controls, high-dose RSVIG administration significantly reduced the incidences of RSV LRTI (P = .01) and moderate-to-severe LRTI (P = .006). RSV-associated hospitalization also was decreased (P = .06) as well as were total RSV-associated days in the intensive care unit (P = .05). Significantly fewer preterm infants developed severe RSV LRTI in the RSVIG group compared with controls (4/58 [7%] vs 14/58 [24%], respectively; P = .01). Adverse reactions occurred in 5% of RSVIG infusions. These were generally mild and included reversible fluid overload, transient fever, and decreases in oxygen saturation. There was one death unrelated to either RSV or RSVIG administration.

Conclusions. Prophylaxis with RSVIG is safe and is currently the only effective means to prevent severe RSV LRTI in high-risk preterm infants.

Submitted on July 25, 1994
Accepted on October 31, 1994




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