Infants born before 32 weeks of gestation or with respiratory disease are most likely to receive palivizumab in the Netherlands

AimPalivizumab is reported to be effective in reducing respiratory syncytial virus hospitalisation. Its licensed uses include infants younger than six months of age, born before 35weeks of gestation or under two years old with congenital heart disease or bronchopulmonary dysplasia. We redressed lack of research in the Netherlands by studying whether infants who met the licensed indications received the drug. MethodsData were obtained from the PHARMO Database Network and The Netherlands Perinatal Registry for all linked infants born between 1 April 1999 and 31 March 2007. Determinants for receiving palivizumab were examined using logistic regression analyses. ResultsOnly 15% of the 3321 infants who met the licensed indications received palivizumab and the strongest predictor was being born before 32weeks of gestation, with an odds ratio of 49.1 (95% confidence interval 31.5-76.4). However, 50% of infants born before 32weeks did not receive palivizumab and the subanalyses showed that the probability increased for infants born in later years, those who had respiratory distress syndrome and those hospitalised during the respiratory syncytial virus season. ConclusionOnly 15% of eligible infants in the Netherlands received palivizumab and they were mostly born before 32weeks, in line with Dutch guidelines.