Palivizumab prophylaxis for respiratory syncytial virus infection

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The report of Simoes et al on the effect of palivizumab prophylaxis on subsequent recurrent wheezing will be cited often. The study report deserves careful reading. The accompanying editorial attempts to put the investigation methodology and findings into context. Although substantial limitations of study design make it inappropriate to draw conclusions about the worth of palivizumab prophylaxis in reducing recurrent wheezing, or to support a broadening of recommendation for its use, the study fosters the hypothesis that a complex relationship exists between respiratory syncytial virus (RSV) infection and asthma, in which host genetics, developmental biology, and infection play variable roles. Prevention of premature birth and prevention of RSV through vaccination is where Willie Sutton would go.