Practice recommendations for respiratory syncytial virus prophylaxis among children in Hong Kong.

Hong Kong has a high burden of hospitalisations associated with respiratory syncytial virus (RSV) infection in young children. Most international guidelines concerning RSV prophylaxis are based on studies conducted in temperate climates and may not fully apply to subtropical locations such as Hong Kong. In July 2022, a group of nine experts in neonatology, paediatric intensive care, paediatric respiratory medicine, and paediatric cardiology in Hong Kong convened to formulate recommendations for RSV prophylaxis. The recommendations were based on literature review and expert discussion. Each expert reviewed evidence specific to a particular area and formulated consensus statements. The expert panel reached a consensus on 11 statements, which addressed the epidemiology of RSV infection in Hong Kong, the goals and outcomes of RSV prophylaxis in preterm infants and infants with congenital heart disease or bronchopulmonary dysplasia, safety, and cost. Because there is no clear seasonality pattern for RSV infection in Hong Kong, panel members emphasised using gestational age, rather than season, to guide prophylaxis recommendations. The experts agreed that RSV prophylaxis should be considered for 5 to 6 months after hospital discharge among preterm infants born at <29 weeks gestational age; it should also be considered for children aged <1 year with haemodynamically significant congenital heart disease or bronchopulmonary dysplasia.