Hospital fusion

Palivizumab is a monoclonal antibody that binds to the fusion protein of respiratory syncytial virus, preventing infection in susceptible cells in the airways. It is used in neonates at risk for this viral infection and reduces the frequency of infection and hospitalization by about 50% (see Chapter 49). 

Respiratory syncytial virus (RSV) infection represents a major cause of pediatric respiratory hospitalizations. RSV is the most common cause of lower respiratory tract infection in infants. Palivizumab (Synagis) is a humanized monoclonal antibody to the fusion protein of RSV, and is active in animal models for prevention of pulmonary RSV replication [241]. Based on a phase I/II multicenter, randomized, double-blind, placebo-controlled, dose escalation trial by Subramanian et al. in premature infants or infants with bronchopulmonary dysplasia, it was found that the mean half-life of 20 days was comparable with that of other immunoglobulin G preparations. Mean trough serum concentrations 30 days after infusion were 6.8, 36.1, and 60.6pg/mL for the 3-, 10-, and 15-mg/kg dose groups, respectively. Mean serum concentrations of palivizumab that have been shown to produce a 2-log reduction in pulmonary RSV titer in cotton rats were maintained when 10- or 15-mg/kg palivizumab was given every 30 days to pediatric patients at high risk... 

Cahill KS, Chi JH, Day A, Claus EB. Prevalence, complications, and hospital charges associated with use of bone-morphogenetic proteins in spinal fusion procedures. JAMA 2009 302(1) 58-66. 

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