Antiviral chemotherapy and prophylaxis of viral respiratory disease

Respiratory viruses continue to be major causes of morbidity and mortality. Currently available chemotherapy is limited to oral amantadine for uncomplicated influenza A and aerosolized ribavirin for respiratory syncytial virus (RSV) infections. Amantadine is also efficacious for chemoprophylaxis of influenza A virus infections. Rimantadine has similar clinical efficacy and is better tolerated than amantadine. Aerosolized ribavirin may be useful in the treatment of serious respiratory illness caused by viruses other than RSV. Intranasal application of interferon is effective in interrupting the spread of rhinovirus colds in families, but chronic use is limited by nasal toxicity. Several newer agents and approaches for chemoprophylaxis and therapy are at different stages of clinical investigation. Combinations of antiviral agents may offer the best therapeutic advantage but have not been adequately tested in man. As additional drugs become available and uses expand for the currently available agents, rapid viral diagnosis will assume an increasingly important role in their optimal use.