- Saudi Initiative of Bronchiolitis Diagnosis, Management, and Prevention recommendations on using Palivizumab across different patients’ categories.11
| Patient segment | Recommendations | Level of evidence |
|---|---|---|
| Early preterm (=28 weeks, 6 days GA) | ≤12 months of age | 1B |
| Mid preterm (29 weeks GA, 0 days to 32 weeks, 6 days GA) | ≤6 months of age | 1B |
| Late preterm (33 weeks, 0 days weeks GA to 35 weeks, 0 days GA) | ≤6 months of age at the start of the RSV season OR born during RSV season with at least one of the following risk factors: Attendance at child care Children <5 years of age who live permanently in the same household (including siblings) Exposure to environmental air pollutants | 1B |
| Infants and children with CLD | <12 months for all; <24 months if still receiving medications for CLD within 6 months from the beginning of the epidemic season | 1B |
| Infants and children with hemodynamically significant CHD | <12 months for all; <24 months if still receiving medications for the cardiac condition <6 months from the beginning of the epidemic season. Postoperative dose after cardio bypass | 1B |
| Children with anatomic pulmonary abnormalities or neuromuscular disorders | <24 months may be considered for infants with impaired ability to handle respiratory secretions. | 3B |
| Immunocompromised children | <24 months may be considered for children who are profoundly immunocompromised during the RSV season | 2B |
| Children with down syndrome | Recommended for children with accompanying qualifying heart disease, CLD, airway clearance issues, or premature birth (<35 weeks, 0 days GA) | 2B |
| Children with cystic fibrosis | <12 months with clinical evidence of CLD and/or nutritional compromise for <24 months with manifestations of severe lung disease or weight for length <10th percentile | 2A |
| Special situations: If an infant who is receiving prophylaxis experiences a breakthrough of RSV | If an infant who is receiving prophylaxis experiences a breakthrough of RSV, the monthly prophylaxis should continue as planned until a maximum of 5 doses have been administered | 3B |
RSV: Respiratory Syncytial Virus, CLD: chronic lung disease, CHD: congenital heart disease, GA: gestational age