<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1683-9803</journal-id>
<journal-title><![CDATA[Pediatría (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[Pediatr. (Asunción)]]></abbrev-journal-title>
<issn>1683-9803</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1683-98032026000100110</article-id>
<article-id pub-id-type="doi">10.31698/ped.53012026015</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Prevención de las infecciones respiratorias graves por virus sincitial respiratorio. II Consenso Interinstitucional]]></article-title>
<article-title xml:lang="en"><![CDATA[Prevention of severe respiratory infections caused by respiratory syncytial virus. II inter-institutional consensus]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez de Cuellar]]></surname>
<given-names><![CDATA[Celia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gimenez]]></surname>
<given-names><![CDATA[Edgar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Weber]]></surname>
<given-names><![CDATA[Ernesto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araya]]></surname>
<given-names><![CDATA[Soraya]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Campuzano de Rolon]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Acuña]]></surname>
<given-names><![CDATA[Julia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cousirat]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lovera]]></surname>
<given-names><![CDATA[Dolores]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jimmy Jiménez]]></surname>
<given-names><![CDATA[Hassel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ghesi]]></surname>
<given-names><![CDATA[Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Genes]]></surname>
<given-names><![CDATA[Larissa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro]]></surname>
<given-names><![CDATA[Héctor]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fonseca]]></surname>
<given-names><![CDATA[Rosanna]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Benítez]]></surname>
<given-names><![CDATA[Irene]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[Mónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lezcano]]></surname>
<given-names><![CDATA[Federico]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rolón]]></surname>
<given-names><![CDATA[Roger]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fiqueredo]]></surname>
<given-names><![CDATA[Carmen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caballero]]></surname>
<given-names><![CDATA[Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pereira Ferreira]]></surname>
<given-names><![CDATA[Sara Lucia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González-de-Soto]]></surname>
<given-names><![CDATA[Mirtha]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Suarez]]></surname>
<given-names><![CDATA[Zully]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Velázquez]]></surname>
<given-names><![CDATA[Sheila]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Godoy]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Cátedra de Pediatría]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Medicina Tropical  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Nacional de Concepción  ]]></institution>
<addr-line><![CDATA[Concepción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Sanatorio Adventista de Asunción  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Programa Ampliado de Inmunizaciones ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Sociedad Paraguaya de Pediatría  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Instituto de Previsión Social  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Hospital de Clínicas]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,Hospital General Pediátrico Niños de Acosta Ñu  ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A10">
<institution><![CDATA[,Hospital General Materno Infantil San Pablo Departamento de Neonatología ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A11">
<institution><![CDATA[,Sociedad Paraguaya de Medicina Familiar  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A12">
<institution><![CDATA[,Instituto Nacional de Salud  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A13">
<institution><![CDATA[,Hospital de Policía Rigoberto Caballero  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A14">
<institution><![CDATA[,Universidad Nacional de Caaguazú  ]]></institution>
<addr-line><![CDATA[Caaguazú ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A15">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Dirección de la Salud Integral de la Niñez y Adolescencia ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A16">
<institution><![CDATA[,Fuerzas Armadas de la Nación Hospital Militar ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2026</year>
</pub-date>
<volume>53</volume>
<numero>1</numero>
<fpage>110</fpage>
<lpage>124</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1683-98032026000100110&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1683-98032026000100110&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1683-98032026000100110&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN El virus respiratorio sincitial (VSR), principal causa de infección respiratoria aguda grave en lactantes, genera alta morbilidad y mortalidad. Anualmente causa más de 33 millones de infecciones respiratorias bajas, 3,2 millones de hospitalizaciones y hasta 149.000 muertes en menores de cinco años. En Paraguay, es una de las principales causas de hospitalización en menores de un año. Tradicionalmente, la prevención se enfocaba en lactantes de alto riesgo; sin embargo, el 80 % de las hospitalizaciones por VSR ocurren en lactantes sanos, lo que impulsó el desarrollo de nuevas estrategias preventivas dirigidas a lactantes menores de un año. Entre estas estrategias, destaca el anticuerpo monoclonal de acción prolongada Nirsevimab, que proporciona inmunidad pasiva con una única dosis que protege durante toda la temporada de circulación viral. La evidencia en vida real ha mostrado resultados relevantes. En Galicia y Chile, Nirsevimab redujo significativamente las hospitalizaciones por infecciones respiratorias bajas asociadas al VSR, los ingresos a unidades de cuidados intensivos y la mortalidad. En el 2025, Paraguay incorporó el Nirsevimab para la prevención de infecciones por VSR en lactantes nacidos entre enero y julio y grupos de riesgo. Durante la primera temporada de implementación se observó una disminución significativa de casos, reducción de casos severos, menor número de ingresos a unidades de cuidados intensivos y ausencia de muertes por VSR. Estos resultados, destacan el impacto sanitario de la inmunización con Nirsevimab y respaldan su continuidad como única estrategia para reducir la carga de enfermedad por VSR en lactantes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Respiratory syncytial virus (RSV), the leading cause of severe acute respiratory infection in infants, generates high morbidity and mortality. Annually, it causes more than 33 million lower respiratory infections, 3.2 million hospitalizations, and up to 149,000 deaths in children under five years of age. In Paraguay, it is one of the leading causes of hospitalization in children under one year of age. Traditionally, prevention focused on high-risk infants; however, 80% of RSV hospitalizations occur in healthy infants, which has driven the development of new preventive strategies targeting infants under one year of age. Among these strategies, the long-acting monoclonal antibody nirsevimab stands out, providing passive immunity with a single dose that protects throughout the viral circulation season. Real-world evidence has shown relevant results. In Galicia and Chile, nirsevimab significantly reduced hospitalizations for RSV-associated lower respiratory infections, admissions to intensive care units, and mortality. In 2025, Paraguay incorporated nirsevimab for the prevention of RSV infections in infants born between January and July and in at-risk groups. During the first season of implementation, a significant decrease in cases, a reduction in severe cases, fewer admissions to intensive care units, and no RSV-related deaths were observed. These results highlight the health impact of nirsevimab immunization and support its continued use as the only strategy to reduce the burden of RSV disease in infants.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Virus sincitial respiratorio]]></kwd>
<kwd lng="es"><![CDATA[infección respiratoria aguda baja]]></kwd>
<kwd lng="es"><![CDATA[nirsevimab]]></kwd>
<kwd lng="en"><![CDATA[Respiratory syncytial virus]]></kwd>
<kwd lng="en"><![CDATA[acute lower respiratory infection]]></kwd>
<kwd lng="en"><![CDATA[nirsevimab]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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