I am a senior nursing student from the Univ. of MN responding to the question about treatment of RSV with Ribavirin. I have found that Ribavirin is being used to treat severe cases of RSV. It is the only drug licensed to treat RSV in the United States (www.rsvinfo.com). It inhibits RSV replication during the active replication phase. According to www.rsvinfo.com,
it significantly improves arterial blood oxygenation, which accelerates patient recovery and decreases the need for supplemental oxygen; decreases illness severity; and decreases viral shedding. Ribavirin is being used in combination with IV fluids, respiratory support, and bronchodilators (Wong, 1999). Ribavirin does have serious potential side effects for the patient (hypotension, cardiac arrest) and for health care workers (reproductive risk-causes human fetal risk) (Deglin and Vallerand, 1999). Two recently published articles offer conflicting evidence regarding the effectiveness of Ribavirin. The American Journal of Resp. and Critical Care Med. states that Ribavirin is not effective in reducing the length of ventilation, length of oxygen therapy, and length of ICU stay in infants with no underlying illness ventilated for respiratory distress secondary to RSV bronchiolitis. In contrast, the Archives of Pediatric Adolescent Med. reports no increase in reactive airway disease, wheezing, and pneumonia (potential complications of RSV) in infants treated with Ribavirin. They suggest that there is a long-term beneficial effect with Ribavirin therapy. There is no vaccine for RSV, but currently RespiGam (an RSV immune globulin) is being used prophlactically to prevent RSV infection in high risk infants (Wong, 1999).
Deglin, J. and Vallerand, A. (1999). Davis's drug guide for nurses (6th ed.). Philadelphia, PA: F.A. Davis Company.
Guerguerian, A.M., Gauthier, M. Lebel, M., Farrell, C.A. and Lacroix, J. (1999). Ribavirin in ventilated respiratory syncytial virus bronchiolitis: a randomized, placebo-controlled trial. American Journal of Critical Care Medicine, 160, 829-834.
Managing the symptoms of RSV. [online]. Available: http://www.rsvinfo.com/managing/virazole/html
Rodriguez, W., Arrobio, J., Fink, R., Kim, H. and Milburn, C. (1999). Prospective follow up and pulmonary functions from a placebo-controlled randomized trial of ribavirin therapy in RSV bronchiolitis. Archives of Pediatric Adolescent Medicine, 153, 469-474.
Wong, D., Hockenberry-Eaton, M., Winkelstein, M., Wilson, D., Ahmann, E. and DiVito-Thomas, P. (1999). Whaley and Wong's nursing care of infants and children (6th ed.). St. Louis, MO: Mosby, Inc.