PURPOSE: The purpose of this research was to follow 32 to 35 week infants referred to Mercy Children’s Pulmonary Center who met FDA package insert guidelines for Synagis prophylaxis and describe their experience in the 2009- 2010 RSV season. RSV is a common virus present during winter months. It is responsible for approximately 220,000 hospitalizations in infants below one year of age in the United States yearly. Premature infants, those with chronic lung disease or heart disease have a greater risk for RSV hospitalization. There is prophylactic medication, Synagis, that is available. Safety and efficacy of Synagis has been proven. The AAP has set guidelines for considering infants for prophylaxis. In 2009, guidelines changed, deviating from scientific evidence base.
METHODS: We called the care givers of all infants referred to the Mercy RSV program 3 months after RSV season end and obtained information about: 1. Synagis prophylaxis. 2. Risk factors for RSV disease 3. RSV infection 4. office visits/ER, hospitalizations 5. change in their health status Data was analyzed to form a descriptive analysis’ of the group
RESULTS: Total N of 55 patients Ninety percent were below poverty level Seventy percent were male Ninety percent had Siblings Thirty percent had a Family History of Asthma Thirty percent Second smoke exposure Fifty three percent had a RSV infection Sixty six percent of those with RSV were Hospitalized Fifty six percent had a RSV ER Visits Fifty six percent had a RSV Dr. Visits Sixty seven percent had continued wheeze/infections Average length of hospital stays was1.7 days Average cost of hospitalization was $9200.00
CONCLUSIONS: These guidelines had a negative impact on our patient population. Data represents risk factors outside of those identified by AAP.
CLINICAL IMPLICATIONS: Development of guidelines that have the potential to restrict care must be cognizant of the implications to multiple populations to avert causing diparity in a group.
DISCLOSURE: Dawn Bolyard: Consultant fee, speaker bureau, advisory committee, etc.: speaker
The following authors have nothing to disclose: Gayle Cavins
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