Table 3.

Studies on association between palivizumab dosing and RSV-associated hospitalization.

Author, year, and location	Study design	Timeline	Study population	Intervention strategy	Sample size	Dose of palivizumab	RSV hospitalization rate	Conclusion	Quality of study
(17) Forgel et al., 2008, USA [44]	Palivizumab outcome registry review	2000–2004	High risk infants and young children eligible for palivizumab	Association between rates of RSV hospitalization and site of palivizumab administration	17,641 in clinic setting and 1226 in home setting	88% in home setting and 81% in clinic setting received the appropriate number of dosing	Received palivizumab at home: 0.4% (5/1226) Received palivizumab in clinic: 1.2% (207/17,641) (P = 0.0139)	Home administration of palivizumab may be preferred for high risk infants at risk of RSV hospitalization	Low
(18) Palivizumab Outcomes Registry Study Group, 2003, USA [34]	Record review	2000-2001	All children eligible for palivizumab according to AAP guidelines [40]	Received at least one dose of palivizumab	2,049	1,638 of 2,049 (80%) children were compliant with the scheduled dosing of palivizumab  472 (23%) of 2,049 infants missed or had a delay in receiving an injection	RSV hospitalization slightly higher in noncompliant infants (3.4% versus 2.8%, P = 0.48)  Hospitalization rate significantly higher in infants who missed or delayed an injection (4.4% versus 2.4%) (P = 0.020)	Missed or delayed palivizumab injections may increase the incidence of hospitalization	Low
(19) Resch et al., 2006, Austria [43]	Cohort study	2001–2003	Premature infants of GA 29–32 weeks with and without BPD	Comparison between infants receiving adequate dosing of palivizumab and those receiving at least 1 dose of palivizumab	238 children received palivizumab	Mean number of injections/child 2.5 ± 1.6	Adequate prophylaxis: 3.3%  Inadequate prophylaxis: 8.1% (P = 0.07)	Missed or delayed palivizumab injections may increase the incidence of hospitalization	Low
(20) Chadha et al., 2012, USA [42]	Cohort study	2005–2009	Premature infants < 32 week GA	Relation between different dosing rate of palivizumab and hospital admission	1965 infants	0 doses: <29 week GA = 42%, 29–31 week GA = 39.8% At least 1 dose: <29 week GA = 58%, 29–31 week GA = 60.2% Full dose: <29 week GA = 14.8%, 29–31 week GA = 17.6%	Weak positive correlation between palivizumab dosing and hospital admissions P = 0.057  Spearman rho = 0.012	Overall reduced dosing of palivizumab and seasonal variation in severity of RSV disease may have affected the results	Low
(21) Alexander et al., 2012, Australia [37]	Cohort study	2005–2009	Infants with HS-CHD	Patients who received palivizumab on ad hoc basis (2005–2007) versus patients who received it systematically (2008-2009)	120 (3 in 2005–2007 and 117 between 2008 and 2009)	2005–2007: mean 1-2/child 2008-2009: mean 4/child	2005–2007: 7–9 patients/year 2008–2009: 2-3 patients/year (P = 0.03)	Systematic administration of palivizumab reduced hospitalization rates	Low