Respiratory Function; Palivizumab a monoclonal antibody that prevents respiratory syncytial virus, or RSV, in high risk infants did not improve long-term outcomes like respiratory function in children with cystic fibrosis. The AAP does not recommend routine use of palivizumab for RSV prophylaxis in young children with cystic fibrosis (CF).
However, the academy recommends that children with evidence of lung disease or nutritional compromise should be considered for the drug. To have cystic fibrosis, a child must inherit one copy of the cystic fibrosis trans membrane conductance regulator (CFTR) gene mutation from each parent. People who have only one copy of a CFTR gene mutation do not have CF. They are called “CF carriers.”
Aliza K. Fink, DSc, director of epidemiology at the Cystic Fibrosis Foundation; also colleagues analyze data collect through the CF Foundation’s Patient Registry. They focuse on 4,267 children born between 2008 and 2015 who were diagnose with CF within the first 6 months of life. Fink and colleagues specifically examine the relationship between palivizumab administration by age 2 years and lung function at age 7 years, time to first positive Pseudomonas respiratory culture and pulmonary relate hospitalizations by age 7 years.
Palivizumab was given to 1,588 (37%) infants with CF during the study period, the researchers said. The average percent force expiratory volume in 1 second predict at age 7 years was similar between children; who were given palivizumab and those who were not prescribed the drug (98.2 [95% CI; 96.9-99.5] vs. 97.3 [95% CI, 96.1-98.5]). Additionally, Fink and colleagues found that the time to first positive culture for P. aeruginosa a bacterial pathogen that poses a serious risk to patients with CF and the annual risk for hospitalization were both similar between the two groups.
Disease for premature babies
Leonard R. Krilov, MD, FAAP, FIDSA, FPIDS, an Infectious Diseases in Children Editorial Board member; also chairman of the department of pediatrics at New York University’s Winthrop Hospital, wrote in a relate editorial that although palivizumab was approve by the FDA in 1998, optimal indications for its use remain uncertain in this group of children. In an interview, they say’s Infectious Diseases in Children that the AAP’s guidelines was too restrictive.
“They think the first step is to realize that RSV is still a significant disease; so for premature babies even beyond 29 weeks’ gestational age,” he said. “Revisiting the epidemiology has really support that.” However, Krilov said it is unclear at this point what the right changes; hence in the guidance should be. They suggest that a multidisciplinary group from the academy; so including experts in infectious diseases, neonatology, pulmonology and general pediatrics, reevaluate the current recommendations. The AAP told Infectious Diseases in Children that its “recommendations for RSV prophylaxis will remain the same for the upcoming season.”