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The influence over a period of 8 years of patterns of prescribing palizivumab for patients with and without congenitally malformed hearts, and in admissions to paediatric intensive care

Published online by Cambridge University Press:  01 August 2009

Alastair Turner ,
Colin Begg ,
Benjamin Smith  and
Jonathan Coutts
Alastair Turner*
Affiliation:
Department of Paediatric Intensive Care, Royal Hospital for Sick Children, Yorkhill, Glasgow, Scotland;
Colin Begg
Affiliation:
Department of Paediatric Intensive Care, Royal Hospital for Sick Children, Yorkhill, Glasgow, Scotland;
Benjamin Smith
Affiliation:
Department of Paediatric Cardiology, Royal Hospital for Sick Children, Yorkhill, Glasgow, Scotland;
Jonathan Coutts
Affiliation:
Department of Paediatrics, Queen Mother’s Hospital, Yorkhill, Glasgow, Scotland, United Kingdom
*
Correspondence to: Dr Alastair Turner MRCPCH, Department of Paediatric Intensive Care, Royal Hospital for Sick Children, Yorkhill, Glasgow, G3 8SJ, Scotland, United Kingdom. Tel: +44 (0) 141 201 0085; Fax: +44 (0) 141 201 9342; E-mail: alastairturner@nhs.net
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Abstract

Objectives

To describe the pattern of prescribing for palivizumab in the Glasgow area over the period 1999 through 2007, and to compare recent prescribing to the current recommendations by the Joint Committee on Vaccination and Immunisation of the United Kingdom Department of Health. Our secondary objective was to describe admissions to paediatric intensive care in patients with respiratory syncytial virus receiving palivizumab.

Setting

Tertiary children’s hospital out-patient immunisation clinic and paediatric intensive care unit.

Design

Prospective analysis of prescribing and admissions data for the period 1999 through 2007.

Outcome measures

Number of prescriptions and admissions to the paediatric intensive care unit.

Results

The number of children receiving palivizumab annually initially rose more than 5-fold, from 17 in the season of 1999 and 2000 versus 115 in 2004 and 2005, although it has declined in the past 2 years, to 63 in 2006 and 2007, following publication of the recommendations of the Joint Committee on Vaccination and Immunisation established by the United Kingdom Department of Health. There has been no significant change in demographics of patients during this period. Prior to publication of these recommendations, 35 of 44 (80%) patients with congenitally malformed hearts who received palivizumab in the season of 2005 and 2006 deviated from the current recommendations, compared to 5 of 51 (10%) who received palivizumab for non-cardiac indications. No patients who received palivizumab required admission to the paediatric intensive care unit with proven respiratory syncytial virus infection over the 8 year period.

Conclusions

The number of children receiving palivizumab initially increased significantly, although it has now fallen following implementation of national recommendations. Much prescribing, particularly for children with congenitally malformed hearts, did not fulfil current recommendations. The absence of admissions to paediatric intensive care reflects the success of targeted immunisation in our population.

Keywords

Respiratory syncytial virusimmunisationbronchiolitiscongenital heart disease
Type
Original Articles
Information
Cardiology in the Young , Volume 19 , Issue 4 , August 2009 , pp. 346 - 351
Copyright
Copyright © Cambridge University Press 2009

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