Moynihan, J. A., Kim, T. Y., Young, T., & Checchia, P. A. (2004). Journal of Pediatric Health Care, 18(5), 224-227.

Recommendations can be made by professional organizations, but are they followed? The American Academy of Pediatrics (AAP) has recommended that certain children at risk for respiratory syncytial virus (RSV) receive palivizumab as prophylaxis for RSV. This study, a retrospective review of 264 children younger than 2 years with a diagnosis of RSV admitted to a pediatric unit of a children's hospital during the RSV season of October 2000 through April 2001, aimed to find out if the recommendations were being followed. Of these 264 children, 40 qualified to receive palivizumab according to AAP guidelines. Only 14 of them (35%) had received the drug. This was clearly a disappointing finding. When the researchers examined their data to attempt to discover why so few children had received the prophylaxis, they found even more disappointing results. There were no statistically significant differences for age, race, health insurance, or type of pediatric care between those who had received the drug and those who had not. Anecdotally, many of us would assume that the uninsured families would be the ones without the means to obtain the drug, but this was not the case. When the researchers contacted the parents whose children had not received the drug, the parents said they had no knowledge of its importance or the AAP guidelines. The results of this study are a wake-up call for all of us who work with families of premature infants and other at-risk infants. We need to make absolutely sure that these parents know about RSV and know about the need for the seasonal monthly administration of palivizumab as prophylaxis for RSV. This article points out that RSV is the leading cause of hospitalization in this group and the leading viral cause of death. We are our patient's educators. We can't afford to forget to teach about this.

Comment by Margaret Comerford Freda