Therapy of respiratory syncytial virus lower respiratory tract infections

Respiratory syncytial virus (RSV) is the most common cause of severe lower respiratory tract infections (LRTI) in infants. Beside the support therapy by oxygen and rehydratation, bronchodilators and corticosteroids are usually used. Over the last ten years, antibiotic therapy has also been used rather frequently and noncritically. A specific antiviral drug is ribavirin but its application is relatively limited and the results are controversial. Recently, the use of RSV-specific immunoglobulin therapy is possible. There is no efficient vaccine for RSV infections yet, only passive prophylaxis by RSV-immunoglobulin (RSV-IG) or humanised monoclonal antibodies could be used. Surveillance from 1988-94 for Zagreb RSV positive patients who were mainly infants with RSV-LRTI, showed that were applied bronchodilators in 75.6% and corticosteroids in 20% of patients. In 5% of patients mechanical ventilation was applied and specific therapy by ribavirin was not used. Antibiotics were administered in 92.4% of RSV-LRTI patients.