Summary of guideline
Clinical Contents:
- Diagnosis
- Initial illness severity assessment
- Risk factors for severe illness
- Investigations
- SARS-CoV-2 co-infection
- Monitoring
- Respiratory support
- Medication
- Nasal suction and clearance techniques
- Hydration and nutrition
- Discharge planning
- Prevention of RSV bronchiolitis
- Infection control
- Education modules
Technical Contents:
Prevention of RSV bronchiolitis
Infant monoclonal antibody vaccination
Consider providing monoclonal antibody prophylaxis (nirsevimab or palivizumab) during the RSV season to infants at increased risk of severe complications from bronchiolitis (due to the presence of chronic lung disease, congenital heart disease, or birth at <32 weeks’ gestational age). (Evidence quality: moderate; recommendation strength: conditional)
Nirsevimab provides long-acting protection (6 months) from one dose. Palivizumab provides short-acting protection (1 month) and requires 5 to 6 monthly doses during the RSV season.
Consider universal nirsevimab as a population-based approach to reduce morbidity due to RSV bronchiolitis. (Evidence quality: moderate; recommendation strength: conditional)
Maternal active RSV immunisation
Consider universal maternal antenatal immunisation with an RSV prefusion F protein-based vaccine as a population-based approach to reduce morbidity from RSV bronchiolitis. (Evidence quality: moderate; recommendation strength: conditional)
Infant active RSV immunisation
This recommendation refers to the use of active RSV vaccines for infants and excludes passive vaccines (e.g., monoclonal antibodies, as above).
Do not routinely use universal infant RSV immunisation. (Evidence quality: low; recommendation strength: weak)
At the time of publication, there is no approved active vaccine candidate for RSV in infants in Australasia.