1. Insert Program or Hospital Logo Introduction The Respiratory Syncytial virus (RSV) was discovered in 1956 and has been since recognized as one of the most common cause of childhood illness and a major economical burden on health cost payers. RSV can cause URI, LRI ( including Bronchiolitis and pneumonia). Almost 0.5 – 2 % patients will require hospital admission. A large study, carried out at Driscoll, in which the authors reviewed > 3000 patients with RSV admitted between 1991-2002. The author concluded that cconcurrent serious bacterial infections are rare in infants and children hospitalized with RSV LRTI and empiric use of broad spectrum intravenous antibiotics is unnecessary in children with typical s/s of RSV bronchiolitis. The also found that the probability of a WBC < 5000 per millilitre and 15000 – 29,999 per millilitre being associated with a concurrent serious bacterial infection is very low ( 0-5.7 %) and not different from that of a normal WBC ( 3.9- 4.7%). Based on the study results, different educational activities were carried out for medical students, residents and community Paediatricians. We intended to create awareness that unnecessary use of septic/meningitis work up and empiric use of intravenous antibiotics not only increases the cost of medical care but more importantly increases the discomfort of the families and stress of hospital course.. Current status of Respiratory Syncytial Virus Hospitalization at Driscoll Children’s Hospital Syed Tariq Khalil. MD Driscoll Children’s Hospital, Corpus Christi, Tx Resident III Comparison of Antibiotic usage Abstract We study the current trends in the hospital course of patients admitted for RSV. We compare the utilization of WBC, cultures and IV antibiotics with the previous study. We also looked at the Palivizumab utilization in high risk patients as described in AAP guideline. Method 127 patients were identified, 72 (57%) were males and 55 (43%) were females. 103 (81.1%) were less than 12 months of age. We retrospectively reviewed the medical record of infants and children admitted with RSV infection. Subjects were identified via a medical records search from Jan 1, 2011 through Jan 30 th, 2012 for the following ICD 9 codes either a primary or secondary discharge diagnosis: RSV Bronchiolitis (466.11), RSV pneumonia (480.1) and RSV not otherwise specified (079.6). Conclusions Our study replicates the results of the previous study conducted at Driscoll Children’s hospital that serious bacterial infection is rare in patients with RSV LRTI and performing full septic/meningitis work ups on admission in infants and children with typical s/s of RSV bronchiolitis and a positive RSV rapid antigen test/PCR even in the presence of fever is unnecessary. Despite all the direct and indirect educational activities to create awareness of typical RSV course, the use of intravenous antibiotics is still unacceptably high. Palivizumab is a useful tool in the management of high risk groups as identified in AAP guidelines but it is under utilized especially in the at risk group recently added in the AAP guideline. Having said that, septic workup and IV antibiotics should be considered in patients with atypical s/s or clinical courses due to small but real possibility of concurrent serious bacterial infection”. References 1.Purcell K, Fergie J. Concurrent serious bacterial infection in 2396 infants and children hospitalized with respiratory syncytial virus lower respiratory tract infections. Arch Pediatr adolesc Med/vol.156,Apr 2002. 2.Purcell K, Fergie J. Lack of usefulness of an abnormal white blood cell count for predicting a concurrent serious bacterial infection in infants and young children hospitalized with respiratory syncytial virus lower respiratory tract infect. The pediatric infectious disease journal.volume 26, Number 4, April 2007. 3. Modified Recommendations for Use of Palivizumab for Prevention of Respiratory Syncytial Virus infections Committee on Infectious Diseases, Paediatrics December 2009; 124:6 1694-1701; 2013 Texas Pediatric Society Electronic Poster Contest Fever > 38 C ° Cultures Insert Program or Hospital Logo Utilization of Cultures Usefulness of high WBC for predicting a Concurrent serious bacterial infection Febrile patients : 69 48 febrile patients had WBC and a culture Palivizumab utilization Result Concurrent serious bacterial infections are rare in infants and children hospitalized with RSV LRTI. Despite clear evidence use of different cultures and IV antibiotics is still high The study also indicates that Palivizumab has been under utilized in high risk patients identified in AAP guidelines. Limitations Retrospective study Relatively small sample size No data was obtained on chest x-rays We suggest a larger prospective study for uniform gathering of clinical and laboratory information