Abstract：
Uniformity and compliance with clinical practice guidelines (CPGs) for use of palivizumab in preventing severe respiratory syncytial viral infection in Australian high-risk infants remain unclear.
An online survey was conducted across the Australian and New Zealand Neonatal Network (ANZNN) to determine clinical practices around palivizumab. A literature search was also performed to identify and compare national and international guidelines.
A total of 65 of 422 ANZNN members completed the survey. Respondents included 61 senior medical staff of consultants/staff specialists (78%) and four nursing staff (6%). According to the survey, infants most likely to be recommended palivizumab included preterm infants born <29 weeks gestational age (GA) (30%), children with chronic lung diseases (CLDs) born <32 weeks GA (40%), and with hemodynamically significant heart disease (35%). Many of the respondents (53%) stated that CPGs for palivizumab were developed locally. Literature search identified 20 guidelines (10 international and 10 domestic); 16 (80%) recommended palivizumab use in preterm infants, 16 (80%) recommended use in infants with CLD, 17 (85%) in congenital heart disease and 6 (30%) in bronchopulmonary dysplasia (BPD). Eight (40%) guidelines provided specific recommendations for immunocompromised infants. Canada, Western Australia, and American Academy of Paediatrics provided recommendations for Indigenous children. Frequency and dosage of palivizumab was universal across all CPGs. None of the international guidelines obtained were from low- or middle-income countries.
Standardization of CPGs may improve clinical decision making around use of palivizumab in high-risk infants.
An online survey was conducted across the Australian and New Zealand Neonatal Network (ANZNN) to determine clinical practices around palivizumab. A literature search was also performed to identify and compare national and international guidelines.
A total of 65 of 422 ANZNN members completed the survey. Respondents included 61 senior medical staff of consultants/staff specialists (78%) and four nursing staff (6%). According to the survey, infants most likely to be recommended palivizumab included preterm infants born <29 weeks gestational age (GA) (30%), children with chronic lung diseases (CLDs) born <32 weeks GA (40%), and with hemodynamically significant heart disease (35%). Many of the respondents (53%) stated that CPGs for palivizumab were developed locally. Literature search identified 20 guidelines (10 international and 10 domestic); 16 (80%) recommended palivizumab use in preterm infants, 16 (80%) recommended use in infants with CLD, 17 (85%) in congenital heart disease and 6 (30%) in bronchopulmonary dysplasia (BPD). Eight (40%) guidelines provided specific recommendations for immunocompromised infants. Canada, Western Australia, and American Academy of Paediatrics provided recommendations for Indigenous children. Frequency and dosage of palivizumab was universal across all CPGs. None of the international guidelines obtained were from low- or middle-income countries.
Standardization of CPGs may improve clinical decision making around use of palivizumab in high-risk infants.
摘要：
背景：在澳大利亚高危婴儿中使用帕利珠单抗预防严重RSV感染的临床实践指南（CPG）的一致性和依从性仍不清楚。
方法：在澳大利亚和新西兰新生儿网络（ANZNN）进行了一项在线调查，以确定帕利珠单抗的临床实践。还进行了文献检索以确定和比较国家和国际指南。
结果：422名ANZNN成员中有65名完成了调查。受访者包括61名顾问/工作人员专家的高级医务人员（78％）和4名护理人员（6％）。根据调查,最有可能推荐帕利珠单抗的婴儿包括胎龄<29周龄(GA)的早产儿(30%),患有慢性肺病（CLDs）的儿童出生<32周GA（40％），和血液动力学显著的心脏病（35％）。许多受访者（53％）表示，帕利珠单抗的CPG是在当地开发的。文献检索确定了20个指南（10个国际和10个国内）；16个（80％）推荐帕利珠单抗用于早产儿，16（80％）建议在CLD婴儿中使用，先天性心脏病（CHD）17例（85％），支气管肺发育不良（BPD）6例（30％）。八项（40％）指南为免疫功能低下的婴儿提供了具体建议。加拿大,西澳大利亚,和美国儿科学会为土著儿童提供建议。帕利珠单抗的频率和剂量在所有CPG中是通用的。获得的国际准则都不是来自低收入或中等收入国家。
结论：CPGs的标准化可能会改善高危婴儿使用帕利珠单抗的临床决策。本文受版权保护。保留所有权利。
方法：在澳大利亚和新西兰新生儿网络（ANZNN）进行了一项在线调查，以确定帕利珠单抗的临床实践。还进行了文献检索以确定和比较国家和国际指南。
结果：422名ANZNN成员中有65名完成了调查。受访者包括61名顾问/工作人员专家的高级医务人员（78％）和4名护理人员（6％）。根据调查,最有可能推荐帕利珠单抗的婴儿包括胎龄<29周龄(GA)的早产儿(30%),患有慢性肺病（CLDs）的儿童出生<32周GA（40％），和血液动力学显著的心脏病（35％）。许多受访者（53％）表示，帕利珠单抗的CPG是在当地开发的。文献检索确定了20个指南（10个国际和10个国内）；16个（80％）推荐帕利珠单抗用于早产儿，16（80％）建议在CLD婴儿中使用，先天性心脏病（CHD）17例（85％），支气管肺发育不良（BPD）6例（30％）。八项（40％）指南为免疫功能低下的婴儿提供了具体建议。加拿大,西澳大利亚,和美国儿科学会为土著儿童提供建议。帕利珠单抗的频率和剂量在所有CPG中是通用的。获得的国际准则都不是来自低收入或中等收入国家。
结论：CPGs的标准化可能会改善高危婴儿使用帕利珠单抗的临床决策。本文受版权保护。保留所有权利。
