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首页> 外文期刊>Pediatrics: Official Publication of the American Academy of Pediatrics >Use of palivizumab in primary practice.
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Use of palivizumab in primary practice.

机译：在初步做法中使用Palivizumab。

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OBJECTIVE: To describe the implementation of a program for the use of palivizumab in a general pediatrics office and evaluate adherence to the 2009 American Academy of Pediatrics (AAP) guidelines. METHODS: Pediatricians in a large practice were educated in the diagnosis and management of bronchiolitis, with specific attention to the AAP's palivizumab administration guidelines. During the 2009-2010 and 2010-2011 respiratory syncytial virus seasons, children were systematically identified and enrolled for palivizumab administration. Indication for administration was determined by gestational age, age at the beginning of the respiratory syncytial virus season, pertinent diagnoses, and presence of risk factors. RESULTS: In the 2009-2010 season, 161 children were enrolled to receive palivizumab, 86 of whom (53%) conformed with AAP guidelines. In contrast, in 2010-2011, a total of 85 children were enrolled to receive palivizumab, and 73 (86%) conformed with the guidelines. As a consequence, the total cost of palivizumab (US Dollars : 511 559 vs 1 500 670) and the cost per child (US Dollars : 6018 vs 9438) were lower in 2010-2011 than in 2009-2010. However, of the children selected within the AAP guidelines, only 29% received the appropriate number of doses, whereas 62% and 9% received fewer or excessive doses, respectively; these findings were similar for the 2 seasons. CONCLUSIONS: In a primary practice, use of palivizumab outside of the AAP guidelines was frequent and manifested as inadequate indications or inadequate number of doses. The former improved with education and standardization of care (suggesting provider problems), while the latter did not (suggesting system problems). Additional interventions are required.
机译：目的：介绍在一般儿科办公室使用Palivizumab的计划，并评估遵守2009年美国儿科学院（AAP）指导方针。方法：在大型实践中的儿科医生受到教育的诊断和管理支气管炎，特别关注AAP的Palivizumab行政指南。在2009 - 2010年和2010-2011呼吸道合胞病毒赛季中，儿童被系统地确定并注册了Palivizumab管理。给药迹象是通过妊娠期，年龄在呼吸合胞病毒季节开始，相关诊断和危险因素的存在的年龄确定的。结果：在2009-2010赛季，161名儿童注册了Palivizumab，其中86名（53％）符合AAP指导方针。相比之下，在2010 - 2011年，共有85名儿童接受Palivizumab，73（86％）符合指导方针。因此，Palivizumab（美元：511 559 VS1 500 670）的总成本和每名儿童的费用（美元：6018与9438）于2010 - 2011年比2009 - 2010年更低。但是，在AAP指南中选择的儿童，只有29％的收到适当数量的剂量，而62％和9％分别接受较少或过量的剂量;这些发现与2个赛季相似。结论：在初步做法中，使用AAP指南之外的Palivizumab经常使用，表现为适当的适应症或剂量数不足。前者改善了护理教育和标准化（建议提供商问题），而后者没有（建议系统问题）。需要额外的干预措施。

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