Clesrovimab: a new monoclonal antibody in the dm+d
The NHS Business Services Authority has added clesrovimab to the dm+d dictionary (version 6.1.0). Clesrovimab is a monoclonal antibody that targets the respiratory syncytial virus (RSV) F protein, used for passive immunisation in high-risk infants during RSV season.
What is clesrovimab used for?
Clesrovimab provides season-long protection against RSV disease in vulnerable infants. It is administered as a single intramuscular injection (typically 50 mg/kg) during autumn and winter months. It is particularly relevant for infants with congenital heart disease, chronic lung disease, or other risk factors that make them susceptible to severe RSV infection.
Event-medicine relevance
Clesrovimab is not typically administered at medical events. It is a preventive agent given in primary care or hospital settings before RSV season. Event responders are unlikely to administer this drug. However, if an infant with a recent clesrovimab injection presents with signs of anaphylaxis or severe hypersensitivity reaction, treat as per anaphylaxis protocol and escalate urgently.
Key cautions and interactions
- Bleeding risk: Avoid intramuscular injection in infants with thrombocytopenia or bleeding disorders.
- Acute illness: Consider deferral if the infant has fever or acute illness.
- Live vaccines: Defer live attenuated vaccines for at least 3 months after clesrovimab administration.
- Inactivated vaccines: May be given concurrently at different injection sites.
- Immunocompromised infants: Efficacy may be reduced; clinical assessment required.
Post-injection monitoring: Vital signs (temperature, respiratory rate, oxygen saturation) should be checked, and the infant observed for 15–30 minutes for signs of hypersensitivity.
Further reading
Always verify current dosing and indications against the BNF and product SmPC before administration. Consult MHRA Product Information for full prescribing details.
For the full dm+d entry, visit the NHS BSA dm+d database.