High dose-short duration ribavirin aerosol treatment--a review

A high-dose, short-duration treatment with ribavirin aerosol consisting of a three-fold increase in concentration of drug (60 mg versus 20 mg of ribavirin per mL in the liquid reservoir of the generator administered for about one-third the time of the standard treatment) was as effective as the standard dosage in the treatment of experimental influenza A and B infections in mice and in the treatment of experimental respiratory syncytial virus infection in cotton rats. Despite some minor pulmonary intolerance, it was considered to be suitable for use in treatment of patients with severe chronic pulmonary disease, and it was well-tolerated and apparently effective in the treatment (by face mask and endotracheal tube) of infants with bronchiolitis principally caused by respiratory syncytial virus infection. Pharmacokinetic studies in mice revealed very high concentrations of drug in the lungs, about triple the level with the standard dose, with similar blood and brain concentrations. Ribavirin concentrations were similarly high in respiratory secretions of infants given the triple dose.