Objective To assess local practice concerning paluvizimab prophylaxis in the congenital heart disease (CHD) population in NHS Highlands, one of fourteen regional health boards in Scotland. Setting: NHS Highlands, an area spanning northwest of Scotland (32,518 km2). Study period: 1st September 2005–March 31st 2008.
Methods Retrospective case note review. All children <1 year attending the NHS Highlands paediatric cardiology clinic between 1st September 2005–March 31st 2008 were included in the audit. Congenital heart disease in these children was diagnosed by cross-sectional echocardiography. Paluvizimab immunisation in the CHD population was ascertained from hospital pharmacy dispensing records.
Results 24 infants with congenital heart disease, age range 21 days to 11 months, formed the at risk population during the winter periods. Paluvizimab prophylaxis was not deemed necessary in 21/24 (88%). Admission rate over study period for all infants with congenital heart disease –13/24 (54%)
Conclusions Though paluvizimab prophylaxis has been proposed to reduce the hospitalisation rate of infants with CHD during winter months, there is reluctance to use it unreservedly in this population of children in Europe. 88% of infants with CHD did not receive paluvizimab prophylaxis during the winter months 2005–2008. The decision not to give paluvizimab is consistent with Scottish national guidelines and comparable to practice in other European countries. Local policy in NHS Highlands for paluvizimab prophylaxis in infants with congenital heart disease is tailored for the minority group within the CHD population in NHS Highlands that require it.