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452 PALIVIZUMAB: ADHERENCE TO AMERICAN ACADEMY OF PEDIATRICS GUIDELINES.
  1. B. Afghani,
  2. T. Ngo,
  3. R. Zeitany,
  4. A. Amin
  1. University of California, Irvine, Orange, CA

Abstract

Background Prophylactic therapy with palivizumab has been shown to be effective in reducing respiratory syncytial virus (RSV)-associated hospitalizations. Because of its high costs we evaluated the extent to which health care providers adhere to guidelines published by the American Academy of Pediatrics (AAP).

Methods All patients who received palivizumab for the 2003-2004 season at 5 different clinics affiliated with University of California, Irvine Medical Center were identified using ICD-9 codes and their charts were reviewed.

Results 181 subjects were identified.

Of 654 injections, 262 (40%) were not in accordance with the AAP guidelines. The main reasons for nonadherence were (a) infants were older than the age recommended by the AAP guidelines, (b) the injections were given too late, in April, when widespread RSV activity had ended, and c) the required risk factors recommended by AAP for the 32- to 35-week gestational age were not documented. Depending on the weight of the patient and the choice of the vial ($690 per 50 mg vial and $1,300 for 100 mg vial), the health care dollars that would be saved for non-adherent injections was estimated to be between $999/patient and $1,882/patient.

Conclusions A significant proportion of palivizumab injections were not in accordance with the AAP guidelines. Intervention programs are needed to improve adherence to AAP guidelines.

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