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Viral lower respiratory tract infections and preterm infants’ healthcare utilisation

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Abstract

The aim of this study was to determine whether respiratory syncytial virus (RSV) and other viral lower respiratory tract infections (LRTI) in prematurely born infants were associated with similar effects on healthcare utilisation and related cost of care in the second compared to the first year after birth. Thirteen infants who had RSV LRTIs (RSV), 21 who had other viral LRTIs (other viral) and 25 had no viral LRTIs (no LRTI) were prospectively followed. Nasopharyngeal aspirates were collected whenever an infant had an LRTI regardless of whether it was in the hospital or in the community. Healthcare utilisation and the health-related cost of care were determined. Only the RSV group compared to the no LRTI group had higher overall respiratory costs in both year 1 (mean, £3,917 versus £24; p < 0.041) and year 2 (mean, £1,164 versus £61; p = 0.012). Only the RSV group required respiratory admissions; the RSV admission rate in year 2 was 3.4 % (number needed to treat 59). Conclusion: RSV LRTIs are associated with increased healthcare utilisation and cost of care in the first and second year; nevertheless, if prophylaxis is to be cost-effective in the second year, a high risk group needs to be identified.

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Abbreviations

BPD:

Bronchopulmonary dysplasia

LRTI:

Lower respiratory tract infection

NNT:

Number needed to treat

NPA:

Nasopharyngeal aspirate

PCR:

Polymerase chain reaction

RSV:

Respiratory syncytial virus

RV:

Rhinovirus

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Funding source

The research was funded/supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. AG is an NIHR Senior Investigator.

Conflict of interest

AG has received grant funding from Abbott Laboratories and MedImmune.

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Authors and Affiliations

  1. Division of Asthma, Allergy and Lung Biology, MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, King’s College London, London, UK

    Simon B. Drysdale, Mireia Alcazar-Paris, Theresa Wilson & Anne Greenough

  2. South London Specialist Virology Centre, King’s College Hospital, London, UK

    Melvyn Smith & Mark Zuckerman

  3. NIHR Biomedical Research Centre, Guy’s and St Thomas’ NHS Foundation Trust and King’s College London, London, UK

    Janet L. Peacock & Anne Greenough

  4. Division of Health and Social Care Research, King’s College London, London, UK

    Janet L. Peacock

  5. Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK

    Sebastian L. Johnston

  6. Neonatal Intensive Care Centre, King’s College Hospital, Denmark Hill, London, SE5 9RS, UK

    Anne Greenough

Authors
  1. Simon B. Drysdale
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  2. Mireia Alcazar-Paris
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  3. Theresa Wilson
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  4. Melvyn Smith
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  5. Mark Zuckerman
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  6. Janet L. Peacock
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  7. Sebastian L. Johnston
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  8. Anne Greenough
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Corresponding author

Correspondence to Anne Greenough.

Additional information

Communicated by Patrick Van Reempts

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Drysdale, S.B., Alcazar-Paris, M., Wilson, T. et al. Viral lower respiratory tract infections and preterm infants’ healthcare utilisation. Eur J Pediatr 174, 209–215 (2015). https://doi.org/10.1007/s00431-014-2380-9

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  • DOI: https://doi.org/10.1007/s00431-014-2380-9

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