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Lancet Respir Med. 2015 Nov;3(11):888-900. doi: 10.1016/S2213-2600(15)00255-6. Epub 2015 Sep 25.

Lower respiratory tract infection caused by respiratory syncytial virus: current management and new therapeutics.

Author information

1
Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands.
2
Translational Pediatrics and Infectious Diseases, Pediatrics Department, Hóspital Clínico Universitario de Santiago de Compostela, University of Santiago, La Coruña, Padova, Italy.
3
Women's and Children's Health Department, Unit of Respiratory Medicine and Allergy, Padova, Italy.
4
Noninvasive ventilation and Sleep Unit, Necker Pediatric University Hospital, Paris Descartes University, Paris, France.
5
Division of Asthma, Allergy and Lung Biology, King's College, London, UK.
6
Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland.
7
Neonataology and Neonatal Intensive Care Unit, S Anna Hospital, Torino, Italy.
8
Pediatric Infectious Diseases, Nationwide Children's Hospital, and The Ohio State University, Columbus, Ohio, United States of America.
9
Center for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh Medical School, Edinburgh, UK.
10
University of Manchester, Manchester, UK; Allergy Dept 2nd Pediatric Clinic, University of Athens, Athens, Greece.
11
Pediatric Infectious Diseases, Vanderbilt University School of Medicine, Nashville, TN, USA.
12
Pediatric Infectious Diseases Research Group, St George's University London, UK.
13
Pediatric Pulmonology Unit, Pontifícia Universidade Católica RS, Porto Alegre, Brazil; Hospital for Sick Children, Toronto, Canada.
14
Department of Science and Technology/ National Research Foundation: Vaccine Preventable Diseases, University of Witwatersrand, Johannesburg, South Africa; Medical Research Council, Respiratory and Meningeal Pathogens Research Unit, University of Witwatersrand, Johannesburg, South Africa.
15
Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands. Electronic address: l.bont@umcutrecht.nl.

Abstract

Respiratory syncytial virus (RSV) is a major worldwide cause of morbidity and mortality in children under five years of age. Evidence-based management guidelines suggest that there is no effective treatment for RSV lower respiratory tract infection (LRTI) and that supportive care, ie, hydration and oxygenation, remains the cornerstone of clinical management. However, RSV treatments in development in the past decade include 10 vaccines and 11 therapeutic agents in active clinical trials. Maternal vaccination is particularly relevant because the most severe disease occurs within the first 6 months of life, when children are unlikely to benefit from active immunisation. We must optimise the implementation of novel RSV therapeutics by understanding the target populations, showing safety, and striving for acceptable pricing in the context of this worldwide health problem. In this Review, we outline the limitations of RSV LRTI management, the drugs in development, and the remaining challenges related to study design, regulatory approval, and implementation.

PMID:
26411809
DOI:
10.1016/S2213-2600(15)00255-6
[Indexed for MEDLINE]

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