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Palivizumab (Synagis) is licensed for prevention of respiratory syncytial virus (RSV) infection in high-risk infants. The American Academy of Pediatrics (AAP) initially recommended its use for all premature infants born at or before 32 weeks gestational age and for high-risk infants born between 32 and 36 weeks. In 2014, based on a cost-benefit analysis, the AAP issued controversial new guidelines, restricting palivizumab use to otherwise healthy premature infants born at or before 29 weeks (NEJM Journal Watch Pediatr Adolesc Med Sep 2014 and Pediatrics 2014; 134:415).
In this retrospective study from nine Texas Medicaid managed care health programs, researchers assessed the consequences of less restrictive guidelines over three RSV seasons.…