AAP Releases Guidance for Respiratory Syncytial Virus Infection

The American Academy of Pediatrics (AAP) has released interim guidance on the use of palivizumab, a monoclonal antibody, for the treatment of severe lower respiratory tract infections in infants due to respiratory syncytial virus (RSV).

The new guidance comes as a result of an unusual increase in cases over the spring and summer, a time when respiratory infections due to RSV are typically at a low.

The AAP’s 2014 policy statement recommends the use of palivizumab be considered for patients at significant risk of severe RSV disease during the typical season, in effort to decrease the risk of hospitalization. Up to 5 doses are recommended monthly over the typical 6-month RSV season.

The new interim guidance now recommends that palivizumab be considered for at-risk patients in areas with high rates of RSV circulation during the atypical season as well.

The treatment is to be used primarily in infants aged less than 6 months who are at risk for serious disease such as bronchiolitis or pneumonia. However, preterm infants and infants and children with certain medical conditions, including hemodynamically significant congenital heart disease or immunodeficiency, may benefit from the treatment as well.

“The AAP recognizes the importance of maintaining flexible approaches including early initiation of palivizumab administration during this atypical interseasonal change in RSV epidemiology in 2021,” they concluded. “Pediatric health care leaders will be key leaders to inform ongoing need in communities warranting specialized consideration. The need for palivizumab administration to eligible infants during this atypical interseason should be supported where activity approaches fall-winter season and should be reassessed at least monthly. This guidance is not meant to supplant typical seasonal palivizumab administration guidance.”

—Leigh Precopio

Reference:

Interim guidance for the use of palivizumab prophylaxis to prevent hospitalization from severe respiratory syncytial virus infection during the current atypical interseasonal RSV spread. News release. American Academy of Pediatrics. August 8, 2021. Accessed August 12, 2021. https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/interim-guidance-for-use-of-palivizumab-prophylaxis-to-prevent-hospitalization/