Palivizumab prophylaxis in infants with cystic fibrosis does not delay first isolation of Pseudomonas aeruginosa or Staphylococcus aureus
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Respiratory syncytial virus (RSV) infections may worsen cystic fibrosis (CF) lung disease and favor Pseudomonas aeruginosa (Pa) or Staphylococcus aureus (Sa) acquisition, which is of particular importance in the youngest patients. We aimed to determine the effectiveness of PVZ on microbiological outcomes in young children with CF. We conducted a retrospective case–control study to compare these outcomes in children who systematically received PVZ (PVZ+; n = 40) or not (PVZ−; n = 140). One case was matched with at least three same-gender controls born the same year and month. Median (range) age at first Pa isolation was not statistically different between PVZ− (12.3 [3.8–32.6] months) and PVZ+ (10.4 [1.2–33.0] months; p = 0.953) patients. A similar trend was found for Sa (PVZ+: 6.4 [2.0–59.0] months; PVZ−: 3.8 [0.1–74.1] months; p = 0.191). The proportion of Pa isolations by 3 years of age did not differ between groups (PVZ+ 40% vs. PVZ− 41.4%), but this proportion was higher for Sa in the PVZ+ group (97%) than in the PVZ− group (85%; p = 0.001). Healthcare consumption and growth outcomes did not significantly differ between groups.
What is known:
• Palivizumab is the only available monoclonal antibody against respiratory syncytial virus infection.
• Whether or not it is useful in infants with cystic fibrosis remains controversial.
What is new:
• Palivizumab does not delay key pathogens (Pseudomonas aeruginosa, Staphylococcus aureus) first isolation in young children with cystic fibrosis.
• Palivizumab does not reduce healthcare consumption or improve growth during the first 3 years of life of young children with cystic fibrosis.
KeywordsInfants Toddlers Cystic fibrosis Palivizumab Pseudomonas aeruginosa Staphylococcus aureus
Lower respiratory tract infection
Respiratory syncytial virus
We thank the French CF patient organization “Vaincre la Mucoviscidose” for providing data from the national CF registry. We thank Anne Doleans-Jordheim and Florence Morfin-Sherpa for valuable discussions that enhanced this manuscript. We thank Philipp Robinson (DRCI-Hospices Civils de Lyon) for help in preparing the manuscript.
CB: data collection and analysis; first draft manuscript preparation and review
MLD: data analysis, results discussion, manuscript review
SS: statistical analysis
MP: database work-up
LC: data collection, manuscript review
CM: data collection, manuscript review
BKK: study design, results discussion, and manuscript review
PR: study design, data analysis, manuscript writing and reviewing
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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