Human respiratory syncytial virus medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Supportive treatment is the mainstay of therapy for infections caused by human respiratory syncytial virus. Supportive care includes adequate hydration and supplemental oxygen therapy.

Antimicrobial therapy

  • Respiratory syncytial virus treatment
  • Supportive therapy
  • Hydration and supplemental oxygen.
  • Routine use of Ribavirin not recommended. Ribavirin therapy associated with small increases in O2 saturation.
  • No consistent decrease in need for mechanical ventilation or ICU stays. High cost, aerosol administration and potential toxicity[1]
  • Note (1): In adults, Respiratory syncytial virus accounted for 10.6% of hospitalizations for pneumonia, 11.4% for COPD, 7.2% for asthma & 5.4% for CHF in pts >65 yrs of age [2]. Respiratory syncytial virus caused 11% of clinically important respiratory illnesses in military recruits[3]
  • Note (2): Respiratory Syncytial Virus major cause of morbidity in neonates/infants.
  • Note (3): Nucleic acid test now approved to detect 12 respiratory viruses (xTAG Respiratory Viral Panel, Luminex Molecular Diagnostics).
  • Prevention of Respiratory syncytial virus
  • 1. In children <24 months old with chronic lung disease of prematurity (formerly broncho-pulmonary dysplasia) requiring supplemental oxygen or
  • 2. In premature infants (<32 wks gestation) and <6 months old at start of Respiratory syncytial virus season or
  • 3. In children with selected congenital heart diseases.
  • Preferred regimen for prevention of Respiratory syncytial virus: Palivizumab (Synagis) 15 mg per kg IM q month Nov.-April[1]
  • Note : Significant reduction in Respiratory syncytial virus hospitalization among children with congenital heart disease[4]


  1. 1.0 1.1 Committee on Infectious Diseases (2009). "From the American Academy of Pediatrics: Policy statements--Modified recommendations for use of palivizumab for prevention of respiratory syncytial virus infections". Pediatrics. 124 (6): 1694–701. doi:10.1542/peds.2009-2345. PMID 19736258.
  2. Falsey AR, Hennessey PA, Formica MA, Cox C, Walsh EE (2005). "Respiratory syncytial virus infection in elderly and high-risk adults". N Engl J Med. 352 (17): 1749–59. doi:10.1056/NEJMoa043951. PMID 15858184.
  3. O'Shea MK, Ryan MA, Hawksworth AW, Alsip BJ, Gray GC (2005). "Symptomatic respiratory syncytial virus infection in previously healthy young adults living in a crowded military environment". Clin Infect Dis. 41 (3): 311–7. doi:10.1086/431591. PMID 16007526.
  4. Feltes TF, Sondheimer HM (2007). "Palivizumab and the prevention of respiratory syncytial virus illness in pediatric patients with congenital heart disease". Expert Opin Biol Ther. 7 (9): 1471–80. doi:10.1517/14712598.7.9.1471. PMID 17727335.

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