PHILADELPHIA — Infants who receive prophylactic palivizumab at home are more likely to get all their doses on time than are those who receive the injections at their pediatrician's office, Dr. Caroline O. Chua reported at the annual meeting of the Eastern Society for Pediatric Research.
Dr. Chua of the Maria Fareri Children's Hospital, Valhalla, N.Y., did a prospective review that included 1,362 infants eligible for respiratory syncytial virus (RSV) prophylaxis during the 2005–2006 RSV season.
Upon discharge from the neonatal intensive care unit, 744 of the infants were scheduled to receive their monthly injections in their pediatricians' offices. The remaining 618 were scheduled to receive the injections at home through the services of a home health care agency.
All of the infants received their first dose of the drug within 24–48 hours of discharge.
But infants scheduled for at-home therapy received significantly more of their scheduled doses on time (95% compliance rate) than did the in-office group (91% compliance rate).
Total hospitalizations, including those secondary to RSV infection, were significantly higher among the in-office group than the in-home group (16 vs. 2). Hospitalizations caused by RSV infections only also were higher in the in-office group, but the difference was not statistically significant (5 vs. 1).
Although the in-office compliance rate leaves something to be desired, it does show a significant improvement from the rate observed in a similar study performed in the same community during the 2001–2002 RSV season, Dr. Chua said.
That study followed 1,446 infants, 969 of whom received their monthly injections at home. The compliance rate was significantly higher than that observed among the 477 who received their injections in the office setting (98% vs. 89%) (Ped. Infect. Dis. 2004;23:318–22).
“We speculate that the increased compliance in offices could be a reflection of better education on the part of pediatricians or media exposure that reached parents,” she said.
The half-life of palivizumab is only 20 days, Dr. Chua noted. Compliance with the monthly dosing schedule is important to maintain a constantly active trough serum level of the drug (more than 40 mcg/mL).