Home delivery of palivizumab: outcomes and compliance in regional preterm infants.

Palivizumab, a monoclonal antibody against respiratory syncytial virus (RSV), has been shown to be effective in preventing RSV-related hospitalization in preterm infants; however, ensuring infants receive the desired monthly injections remains a challenge. We studied two cohorts of preterm infants and the rate of documented RSV illness in infants receiving palivizumab at home between 1998 and 2000. Medical records were reviewed for the number of doses received, hospitalization for RSV illness, and other demographic data. Parents in Cohort 1, 1998-1999, were prospectively surveyed to determine satisfaction with delivery of palivizumab. In Cohort 1, the home group (n = 32) received 89 +/- 19 percent of their scheduled course as compared to 66 +/- 32 percent in the office group (n = 41, p < .01), with 67 percent in the home group receiving their entire scheduled course as compared to 36 percent in the office group (p = .02). Of the parents surveyed, 70 percent in the home group indicated that they were satisfied with the way palivizumab was administered as compared to 76 percent in the office group (p = .44). In Cohort 2, 1999-2000, 175 infants received palivizumab at home, and 161 of these (92 percent) completed therapy as ordered. None of the infants had a documented infection with RSV. In our population infants receiving palivizumab at home were more likely to receive their entire scheduled course and less likely to miss doses than infants receiving palivizumab in an office setting. The high rate of compliance with home delivery is associated with a low rate of documented severe RSV illness.