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RSV prophylaxis in Down syndrome.

Down syndrome alone is a risk factor for severe respiratory syncytial virus infections of the lower respiratory tract and may merit an indication for prophylaxis with palivizumab, according to Dr. Beatrijs L.P. Bloemers of University Medical Center Utrecht (the Netherlands) and her coauthors.

The Dutch researchers followed 395 children with Down syndrome, of whom 39 were hospitalized for these infections. The hospitalization rate, 9.7%, was 14 times that of the 0.7% for a control group of 276 siblings (Pediatrics 2007;120:e1076-81).

The population came from two studies of Down syndrome children. One looked retrospectively at 206 children who were born during 1976-2005 and followed at an outpatient clinic. The other focused on a nationwide birth cohort of 241 children who were born during 2003-2005, identified prospectively, and followed up to 2 years of age. Clinical data were available for 176 and 219 children, respectively. The control group comprised siblings born between 1976 and 2005. When the two cohorts of children with Down syndrome were combined, 180 children (46%) had a risk factor for severe lower respiratory tract infections caused by respiratory syncytial virus (RSV).

Compared with the general pediatric population, the hospitalized children with Down syndrome may have had more severe infections, the authors wrote. The median duration of hospitalization was 10 days, during which 31 children (80%) used supplemental oxygen and 5 (13%) had mechanical ventilation.

The authors noted that palivizumab is indicated for RSV prophylaxis in young children with known risk factors for severe infection, and that the Down syndrome population had a similar rate of hospitalization to what had been previously reported in children with prematurity, chronic lung disease, and CHD.

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Title Annotation:Clinical Capsules
Publication:Family Practice News
Article Type:Brief article
Geographic Code:1USA
Date:Dec 15, 2007
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