Treatment of RSV
Treatment is largely symptomatic.
Main aim of management is to maintain hydration and oxygenation (1).
- dehydration in children with bronchiolitis may occur secondary to increased respiratory rate, fever, and poor feeding caused by difficulty breathing and nasal secretions.
- IV fluids should be considered in infants with severe respiratory difficulty, a respiratory rate greater than 80 breaths per minute, or those who visibly tire during feeding
- intubation and ventilatory assistance are given if there is severe hypoxia
- humidified oxygen may be required if arterial oxygen tension is low.
- should be used in children with saturations below 90 %
A single trial of a bronchodilator may be useful in children with wheezing but routine use is not recommended (1).
Corticosteroids (oral and inhaled) may be useful in older children with a history of asthma (1).
Ribavarin, a nucleoside analogue which is active in vitro against RSV, has been shown to relieve lower respiratory tract illness in children.
- it is used by inhalation since oral administration is associated with liver and bone marrow toxicity
- not recommended for routine use, reserved for immunosuppressed children with severe RSV infection (1)
- studies have yet to be conducted in adults
Reference:
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