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Arch Pediatr Adolesc Med. 1996 Sep;150(9):942-7.

Ribavirin for respiratory syncytial virus lower respiratory tract infection. A systematic overview.

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  • 1Department of Pediatrics, University of California, San Francisco, USA.

Abstract

OBJECTIVE:

To systematically review the evidence evaluating the efficacy of aerosolized ribavirin for the treatment of infants with respiratory syncytial virus lower respiratory tract infection.

DESIGN:

A computerized search of MEDLINE from 1975 to the present, a review of the reference lists of each retrieved article, and contact with experts.

PATIENTS:

infants with documented respiratory syncytial virus lower respiratory tract infection who were the subjects of 8 double-blind randomized placebo-controlled trials.

METHODS:

Two independent reviewers assessed study quality and extracted data on the study populations, the drug regimens, and clinically relevant outcome measurements.

RESULTS:

Ribavirin does not significantly reduce mortality rate (relative risk [RR] = 0.42, 95% confidence interval [CI] = 0.13, 1.44) or lower the probability of respiratory deterioration (RR = 0.42, 95% CI = 0.16, 1.34) when meta-analysis is used to pool the outcomes of 3 trials, although strong trends in the direction of benefit are present. No study found ribavirin to shorten length of hospitalization. Results on length of ventilation and oxygen supplementation are conflicting.

CONCLUSIONS:

Use of ribavirin in infants with respiratory syncytial virus lower respiratory tract infection is not supported by evidence of significant benefit. However, previous studies lack sufficient power to rule out a potential reduction in mortality rate or respiratory deterioration. A large randomized controlled trial of ribavirin for ventilated and other high-risk patients is needed.

PMID:
8790125
[PubMed - indexed for MEDLINE]
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