Abstract
There was a remarkable incidence of respiratory syncytil virus (RSV) in the 1985-86 winter season. The aerosolized antiviral ribavirin was used in 22 patients with suspected or proven RSV disease. Patients were enrolled if they had disease compatible with RSV and evidence of RSV by culture or antigen detection (RSV-Ag). All patients were seriously ill at initiation of therapy, with 82% requiring intensive care and 64% on assisted ventilation (vent.). Underlying medical conditions included prematurity (30%), immunocompromise (23%), pulmonary or cardiac disease (45%), and bacterial infection (9%). Mean duration of ribavirin therapy was 18 hours daily for 6 d. Therapy was discontinued according to clinical improvement, as well as negative RSV cultures and/or RSV-Ag. Twenty of the 22 patients had confirmatory evidence of RSV. Mean time required for diagnosis by RSV-Ag was 0.5 d. vs. 12 d. by culture. Compared with culture, sensitivity of RSV-Ag was 82% and specificity 96% when not receiving antiviral therapy. Premature infants and those with immunodeficiency or infections responded clinically within 2-3 d. of therapy (mean=2 d. on vent.), whereas those with cardiac or pulmonary disease had a delay in clinical improvement until 5-7 d. after initiation of therapy (mean=5 d. on vent.). There were no deaths or serious complications even in pts. receiving assisted vent, during a portion of ribavirin therapy. In this non-controlled study, specific antiviral therapy was rapidly instituted in a group of high risk patients with clinical and laboratory evidence of improvement.
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Englund, J., Balfour, H. RIBAVIRIN THERAPY IN CRITICALLY ILL CHILDREN. Pediatr Res 21 (Suppl 4), 324 (1987). https://doi.org/10.1203/00006450-198704010-00939
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DOI: https://doi.org/10.1203/00006450-198704010-00939
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