513. Respiratory Syncytial Virus Immunoprophylaxis Use Among Neonatologists and General Pediatricians in the US
Session: Poster Abstract Session: Respiratory Infections: Pediatric
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • 513_IDWPOSTER.pdf (164.5 kB)
  • Background: Data on the clinical use of respiratory syncytial virus immunoprophylaxis (RSV IP) by neonatologists (NEOs) and general pediatricians (PEDs) in preterm infants without chronic lung disease (CLD) or hemodynamically significant congenital heart disease (CHD) are scarce. The purpose of this study was to characterize RSV IP use in preterm infants by NEOs and PEDs in the US.

    Methods: Surveys were sent in May 2014 to NEOs and PEDs listed in AMA's database; those who manage preterm infants without CLD or CHD and recommend RSV IP were surveyed.

    Results: The survey was completed by 203 NEOs and 138 PEDs. Most NEOs (95%) and PEDs (94%) recommended RSV IP, even when poor parental compliance was suspected. Recommendations and receipt of RSV IP were generally consistent with the 2012 AAP guidance; though most also recommended use in 29-31 weeks' gestational age (wGA) infants who are 6 to <12 mo of age at RSV season start (Table). Most common reasons NEOs and PEDs did not recommend RSV IP were parental refusal (40% and 56%) and lack of/insufficient insurance (36% and 60%), respectively. Most NEOs (98%) and PEDs (73%) reported their primary hospital provides the first dose, with NEOs being reported as the primary specialist responsible for prescribing hospital-administered doses.

    Table

    Neonatologists

    Pediatricians

    Recommended
    RSV IP (mean %)

    Received ≥1 dose of RSV IP (mean %)

    Recommended RSV IP (mean %)

    Received ≥1 dose of RSV IP (mean %)

    ≤28 wGA

    <6 months at RSV season start

    95

    93

    80

    79

    6 to <12 months at RSV season start

    85

    79

    75

    73

    29-31 wGA

    <6 months at RSV season start

    92

    89

    79

    77

    6 to <12 months at RSV season start

    56

    51

    67

    59

    32-34 wGA

    <3 months at RSV season start

    No 2012 AAP risk factors

    15

    15

    27

    23

    ≥1 2012 AAP risk factor

    76

    74

    70

    61

    3 to <6 months at RSV season start

    No 2012 AAP risk factors

    10

    10

    21

    16

    ≥1 2012 AAP risk factor

    36

    35

    48

    40

    35 wGA

    <3 months at RSV season start

    No 2012 AAP risk factors

    3

    3

    8

    7

    ≥1 2012 AAP risk factor

    13

    15

    26

    19

    3 to <6 months at RSV season start

    No 2012 AAP risk factors

    1

    2

    6

    6

    ≥1 2012 AAP risk factor

    6

    7

    17

    11

    Conclusion: There is substantial support among NEOs and PEDs for use of RSV IP in subsets of high-risk preterm infants, including those 29-31 wGA, as recommended under the 2012 AAP guidance.

    Prabhu S. Parimi, MD1, Joseph B. Domachowske, MD2, Shelagh Szabo, MSc3, Iqra Syed, MSc4, William V. La Via, MD5, Veena R. Kumar, MD, MPH5 and Kimmie K. Mclaurin, MS5, (1)University of Kansas Medical Center, Kansas City, KS, (2)SUNY Upstate Medical University, Syracuse, NY, (3)Redwood Outcomes, Vancouver, BC, Canada, (4)ICON plc, Vancouver, BC, Canada, (5)AstraZeneca, Gaithersburg, MD

    Disclosures:

    P. S. Parimi, None

    J. B. Domachowske, AstraZeneca: Collaborator , Consultant , Investigator , Scientific Advisor and Speaker's Bureau , Educational grant , Grant recipient and Speaker honorarium

    S. Szabo, None

    I. Syed, ICON plc: Consultant and Employee , Consulting fee

    W. V. La Via, AstraZeneca: Employee , Salary

    V. R. Kumar, AstraZeneca: Employee , Salary

    K. K. Mclaurin, AstraZeneca: Employee , Salary

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.