RESPIRATORY SYNCYTIAL VIRUS-ENRICHED GLOBULIN FOR THE PREVENTION OF ACUTE OTITIS-MEDIA IN HIGH-RISK CHILDREN

Acute otitis media (AOM) has been associated with respiratory syncytia l virus (RSV) infection; AOM develops in up to one third of children w ith RSV illness, A masked multicenter trial used an immune globulin en riched with RSV-neutralizing antibodies (RSVIG) to prevent RSV infecti on of the lower respiratory tract in 249 children with either bronchop ulmonary dysplasia, congenital heart disease, or prematurity, To deter mine whether monthly RSVIG therapy might decrease the incidence of AOM , we retrospectively analyzed the records of 109 children in two of th e centers, RSVIG was administered during RSV season at a high dose of 750 mg/kg monthly or a low dose of 150 mg/kg monthly; control children received no RSVIG, Children were examined for AOM by masked observers using pneumatic otoscopy, No difference in sex, race, underlying diag nosis, number of persons in the home, exposure to smoking, or atopy wa s found between groups studied, In recipients of high doses of RSVIG, significantly less AOM developed per season than in control children ( mean episodes, 0.15 vs 0.78; p = 0.003), and fewer episodes of RSV-rel ated AOM occurred (0 vs 5; p = 0.047), Low doses of RSVIG did not have a clinically significant impact, High doses of RSVIG appeared to have a significant impact on preventing AOM (both RSV- and non-RSV-related AOM) in these-high risk populations, This finding may have important implications in the development of improved preventive modalities for AOM.