Treatment and Prevention of RSV Bronchiolitis

Abstract

Respiratory syncytial virus is a leading cause of bronchiolitis and pneumonia in children worldwide, resulting in significant morbidity and mortality in high-risk individuals. The pediatric populations at high risk for severe RSV infections include patients with cardiac disease, lung disease, immunosuppression, premature birth or healthy infants less than six months of age. Supportive care is the primary treatment of RSV lower respiratory tract infections. Other treatment regimens include the use of bronchodilators and anti-inflammatory agents; however, the use of these agents is controversial due to lack of evidence of efficacy in all studies. Ribavirin, an antiviral agent, has been administered for the treatment of RSV lower respiratory tract infections, but its efficacy has been questioned due to flawed study designs. RSV-IVIG and palivizumab are approved for the prevention of RSV infection in selected children at high risk for serious disease. These agents are equally efficacious and expensive; however, the cost-effectiveness of prophylaxis is unclear. Currently, no vaccines for RSV are available for general use, but research in the area continues. Until a safe, effective and relatively inexpensive method for prophylaxis is available, RSV infections will continue to cause significant morbidity and mortality in children.