Can Ribavirin cure Respiratory Syncytial Virus Infections in Children? Probably not, though it might alter the course of the disease a little

Respiratory syncytial virus (RSV) causes severe bronchiolitis and pneumonia in infants under 6 months old, but ribavirin, an analogue of guanosine, is effective against this virus in vitro. 12 infants (average age 3.9 months) with RSV infection were treatecl with aerosols of 190 Ilg/L ribavirin, 12 hours a day for 3 days, which delivered an estimated 10 mg/kg/day of the drug. Compared with 14 control patients, the treated infants showed no significant difference in the time to discharge from hospital, although by day 3 ratings of the severity of infection (on scale of 0-3) were significantly lower in the treatment group (average 0.6) than in the untreated group (rating 1.3). Viral shedding patterns did not differ between the groups, but 2 weeks after admission, 61 % of control infants showed an increase of at least 4-fold in RSV antibody titres, compared with 20% of.treat!!d infants. There were no differences in haematological or biochemical parameters, and no eVidence of ribavirin toxicity,

The reduced antibody response and the apparently more rapid clinical improvement suggest that ribavarin may be altering the course of the infection, so it must be fully evaluated. T.ber. L.H. et sl.: Pediatrics 72: 673 (Nov 7983)