El virus respiratorio sincitial (VRS) es la causa principal de bronquiolitis en menores de 2 años. Recientemente se ha constatado la eficacia de palivizumab en diversos ensayos clínicos

Evaluar el hipotético impacto de la aplicación de una estrategia asistencial con palivizumab en la prevención de bronquiolitis en prematuros

Se incluye a los neonatos nacidos en nuestro hospital desde enero de 1995 a diciembre de 1998 y que ingresan por bronquiolitis. Aplicando datos del estudio "Impact-RSVquot; se calculan medidas de efecto y de impacto para los diferentes puntos de corte de la edad gestacional en la población a estudio. El análisis coste-eficacia incluye el coste directo de la prescripción de palivizumab y el de la hospitalización

De 7.766 neonatos, hay 56 con edad gestacional ≤ 32 semanas, en 8 (14,28 %) se diagnostica bronquiolitis y en 7 (87,5 %) se aisla VRS. Tras la hipotética profilaxis en prematuros los mejores resultados se obtienen en el grupo de ≤ 30 semanas de gestación, donde el riesgo relativo de ingreso por bronquiolitis es de 12,1 (IC 95 %: 4,8–30,5) necesitando tratar a 9 (coste de 12.915 1) para evitar un ingreso, con un gasto 3,8 veces superior al actual sin profilaxis

Las medidas de impacto y el estudio coste-eficacia ofrecen un método útil para decidir recomendaciones en la prevención de bronquiolitis en prematuros

Respiratory syncytial virus (RSV) is the main cause of bronchiolitis in children aged less than 2 years. The effectiveness of palivizumab has recently been reported in several clinical trials

The aim of this study was to evaluate the hypothetical impact of a treatment strategy using palivizumab for the prevention of bronchiolitis in premature infants

Neonates born in our hospital between January 1995 and December 1998 who were admitted for bronchiolitis were included. Using information from the Impact- RSV study, the effects and impact of different cut-off points in the gestational age of the study group were measured. Cost-effectiveness analysis included the cost of hospitalization as well as the direct cost of palivizumab prescriptions

Of 7,766 newborn infants, 56 had a gestational age of ≤ 32 weeks. Of these, bronchiolitis was diagnosed in eight infants (14.28 %), and RSV was isolated in seven (14.28 %). After hypothetical prophylaxis in premature infants the best results were obtained in the group with a gestational age of ≤ 30 weeks. In this group the relative risk of admission for bronchiolitis was 12.1 (95 % CI: 4.8–30.5) and treatment would be required in nine infants to avoid one admission (cost 312.915), with a cost 3.8 times greater than the current cost, without prophylaxis

easurement of the impact and cost-effectiveness analysis of palivizumab prophylaxis provides a useful method for determining recommendations for the prevention of bronchiolitis in premature infants