Pharmacy Corner: 'Tis the season for RSV

In 2019, the American Academy of Pediatrics (AAP) reaffirmed their stance on the palivizumab prophylaxis in high-risk infants and young children as guided by the 2014 AAP Guidelines. In Montana, RSV season generally commences in late November lasting well into the spring months with the peak incidence being in January through March. Every year, it is important to review the criteria for palivizumab prophylaxis and make your Synagis® list.

1. RSV Season Onset: The RSV season typically commences in November and continues through April but may begin earlier or persist later in certain states. See http://www.cdc.gov/rsv/research/us-surveillance.html. Ideally, Synagis is initiated prior to the RSV season onset.
2. Chronic Lung Disease (CLD) of prematurity (also known as bronchopulmonary dysplasia or BPD) is defined as birth < 32 weeks, 0 days gestation and a requirement of > 21% oxygen for at least 28 days after birth.
3. The following groups of infants with CHD are not at increased risk of RSV infection and generally should NOT receive immunoprophylaxis:
   • Infants and children with hemodynamically insignificant heart disease (e.g., secundum atrial septal defect, small ventricular septal defect, pulmonic stenosis, uncomplicated aortic stenosis, mild coarctation of the aorta, and patent ductus arteriosus).
   • Infants with lesions adequately corrected by surgery, unless they continue to require medication for congestive heart failure
   • Infants with mild cardiomyopathy who are not receiving medical therapy for the condition
   • Children in the second year of life
4. These recommendations apply to qualifying infants in the first year of life who are born within 12 months of onset of the RSV season.

This article was originally published in MT Pediatric Updates - Provider Newsletter issue No.1 (Jan/Feb 2020).

Written by Amber Norbeck, PharmD, BCPPS