TABLE 4.
Current recommendations for respiratory syncytial virus prophylaxis in Canadian children
| Indication | Level of evidence* | Comments |
|---|---|---|
| Infants born at <32 weeks’ and 6 days’ GA who are <6 months of age at the start of the RSV season | A-I | – |
| Infants <2 years of age with CLD who require oxygen, steroids or bronchodilator therapy within 6 months of the preceding RSV season | A-I | – |
| Infants <2 years with hemodynamically significant cyanotic or acyanotic heart disease | A-I | Infants with moderate/severe cardiomyopathy and pulmonary hypertension are at risk and should receive prophylaxis. Infants with uncomplicated ASD, VSD, PDA or stenotic lesions do not qualify for treatment (100) |
| Infants born between 33 to 35 completed weeks’ GA (33 weeks and 0 days to 35 weeks and 6 days) | B-II | A-I evidence (15) exists for infants born between 33 weeks and 0 days, and 34 weeks’ and 6 days’ GA. Use of the Risk Scoring Tool is encouraged to make provincial decisions for prophylaxis between 33 weeks’ and 0 days’, and 35 weeks’ and 6 days’ GA (see Table 2) |
| Children <36 completed weeks’ GA and <6 months of age at the start of the RSV season, residing in isolated northern or remote, rural communities where air transportation to medical care is required | B-II | Require prophylaxis |
| All full-term Inuit infants (>37 weeks’ GA) and <6 months of age at the start of the RSV season who live in remote, northern communities | B-II | Require prophylaxis |
| Infants with underlying medical disorders (eg, cystic fibrosis, immunodeficiency, airway anomalies, Down syndrome or neuromuscular impairments) | C-III | Adjudication/approval by provincial panels on a case-by-case basis |