Alternative Explanation of the Results

In infants born at 29 to 32 weeks’ gestation, Farber et al¹  conclude that palivizumab dispensing reduces respiratory syncytial virus (RSV)-diagnosed hospitalizations but increases hospitalizations due to bronchiolitis without RSV diagnosis. I disagree with the interpretation of study results provided by the authors. By using data reported in Table 2 and Table 5 of the article, I prepared a new table (Table 1). In Table 1, I have collapsed “no palivizumab” and “1–25% eligible doses dispensed” groups into a single category because they did not substantially differ in the frequency of RSV-diagnosed and RSV-undiagnosed admissions. The total, observed admissions (with and without RSV diagnosis) according to palivizumab dispensing are reported in the second column. If no or low (1%–25%) palivizumab eligible dosages were adopted in all infants, we would observe the same frequency of RSV-diagnosed hospitalizations (ie, 5.14%) throughout all infant groups. As a consequence, the total...