[Treatment of RSV in pediatric inpatients (Leave 5) and early effects of nirsevimab passive immunization in a regional German pediatric network].

Inpatient treatment of RSV infection involves non-evidence based measures, including excessive antibiotic therapy. The introduction of nirsevimab as a passive immunization is intended to reduce the number of infants requiring inpatient treatment.Can inpatient treatment of RSV infection be improved in a regional pediatric infectious diseases network? Does the introduction of nirsevimab have an impact on inpatient epidemiology?Prospective study (2024/2025) in six pediatric hospitals in one region. Agreement on a treatment standard including five interventions that should be avoided (Leave 5). Analysis of epidemiology (≤24 months and 25-36 months) 2022-2025.121 Clinical Review Forms (CRF) were collected, 101 (83.5%) patients were≤24 months old. The length of stay was 4±3 days vs. 3.5±2 days (≤24 months vs. 25-36 months). At least one risk factor was documented in 24% (≤24 months) and 25% (25-36 months; p=0.8). In 56% of cases, all 5 Leave 5 measures were avoided (≤24 months 58%, 25-36 months 45%). In patients≤24 months, only 9% received antibiotics. After the introduction of nirsevimab, there was a decrease in the number of RSV treatment cases≤24 months (over 60%; p<0.0001).Evidence-based, predominantly supportive therapy for RSV infection in hospitalized children≤24 months can be promoted through a coordinated approach in a pediatric infectious disease network. Shortly after the introduction of nirsevimab, a clear effect on inpatient epidemiology is already evident.