Related Experiment Video
Updated: Aug 1, 2026
An In vitro Model to Study Immune Responses of Human Peripheral Blood Mononuclear Cells to Human Respiratory Syncytial Virus Infection
Published on: December 10, 2013
Ribavirin for respiratory syncytial virus infection of the lower respiratory tract
1Children's Hospital, MICU, Farley 517, 300 Longwood Avenue, Boston, MA 02115, USA. adrienne.randolph@tch.harvard.edu
Insights
Aerosolized ribavirin may reduce mortality and respiratory deterioration in infants with respiratory syncytial virus (RSV) lower respiratory tract infection. However, larger trials are needed to confirm these findings for RSV treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Respiratory syncytial virus (RSV) is a leading cause of infant pneumonia.
- Ribavirin is the sole antiviral agent currently available for RSV treatment.
- Infant RSV lower respiratory tract infections necessitate effective therapeutic interventions.
Purpose of the Study:
- To evaluate the efficacy of aerosolized ribavirin in treating infants diagnosed with RSV lower respiratory tract infection.
- To synthesize evidence from randomized trials on ribavirin's impact on infant RSV outcomes.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) comparing ribavirin to placebo.
- Searched MEDLINE (1975-1999) and relevant reference lists; contacted experts.
- Included RCTs involving infants and children with RSV lower respiratory tract infection.
Main Results:
- Ten trials involving infants under six months were analyzed.
- Ribavirin showed a trend towards reduced mortality (5.8% vs. 9.7% placebo) and respiratory deterioration (7.1% vs. 18.3% placebo).
- Ribavirin use was associated with shorter hospitalization (1.9 days) and mechanical ventilation (1.2 days).
Conclusions:
- Current trials for RSV lack adequate statistical power for definitive conclusions.
- Evidence suggests ribavirin may decrease mechanical ventilation duration and hospitalization length.
- A large-scale RCT is recommended for ventilated and high-risk infants with RSV.
Objectives:
Respiratory syncytial virus (RSV) is a common cause of pneumonia in infants. Ribavirin is the only antiviral therapy available against RSV. The objective of this review was to assess the effects of aerosolized ribavirin for infants with RSV lower respiratory tract infection.
Search Strategy:
We searched MEDLINE from 1975 to 1999, we scanned reference lists of articles, and we contacted experts in the field.
Selection Criteria:
Randomized trials comparing ribavirin with placebo in infants and children with RSV infection and lower respiratory tract infection.
Data Collection And Analysis:
Two reviewers independently extracted data and assessed trial quality. Unpublished data were requested from authors when necessary.
Main Results:
Ten trials were included. All trials enrolled infants below the age of six months. In four trials with 158 patients, mortality with ribavirin was 5.8% compared with 9.7% with placebo (odds ratio 0.58, 95% confidence interval 0.18 to 1.85). In three trials with 116 patients the probability of respiratory deterioration with ribavirin was 7.1% compared with 18.3% with placebo (odds ratio 0.37, 95% confidence interval 0.12 to 1.18). In three studies with 104 patients the weighted mean difference in days of hospitalization was 1.9 fewer days with ribavirin (95% confidence interval +0.9 to -4.6) and the difference in days of ventilation was 1.2 fewer days with ribavirin (95% confidence interval -0.2 to -3.4).
Reviewer'S Conclusions:
Trials of ribavirin for RSV lack sufficient power to provide reliable estimates of the effects. The cumulative results of three small trials show that ribavirin reduces length of mechanical ventilator support and may reduce days of hospitalization. A large randomized controlled trial of ribavirin for ventilated and other high-risk patients is indicated.
Related Concept Videos
01:31Common Respiratory Disorders
Upper respiratory disorders impact the airways above the vocal cords, encompassing areas like the nose, sinuses, and throat. Various conditions fall under this category, including the common cold and allergic rhinitis. These disorders can stem from several causes,...
01:16Drugs Used in Upper Respiratory Disorders: Overview
Antihistamines (e.g., Benadryl) block histamines from binding. Histamines are chemicals released during an allergic reaction in the body. As a...
01:17Drugs Used in Lower Respiratory Disorders: Overview
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
01:23Acute Respiratory Failure-IV
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:29Respiratory Syncytial Virus Disease