Respiratory syncytial virus infection: Treatment
- Frederick E Barr, MD
Frederick E Barr, MD
- Suzan B Thames Professor and Chair of Pediatrics
- Batson Children's Hospital
- University of Mississippi Medical Center
- Barney S Graham, MD, PhD
Barney S Graham, MD, PhD
- Deputy Director
- Viral Pathogenesis Research
- Bethesda, MD
- Section Editors
- Morven S Edwards, MD
Morven S Edwards, MD
- Section Editor — Pediatric Infectious Diseases
- Professor of Pediatrics
- Baylor College of Medicine
- George B Mallory, MD
George B Mallory, MD
- Section Editor — Pediatric Pulmonology
- Associate Professor of Pediatrics
- Baylor College of Medicine
Respiratory syncytial virus (RSV) causes acute respiratory tract illness in persons of all ages. Almost all children are infected by two years of age, and reinfection is common . The clinical manifestations vary with age, health status, and whether the infection is primary or secondary.
The treatment of respiratory syncytial virus infection in infants, children, and adults will be discussed here. The epidemiology, microbiology, clinical manifestations, diagnosis, and prevention of RSV infection are discussed separately. (See "Respiratory syncytial virus infection: Clinical features and diagnosis" and "Respiratory syncytial virus infection: Prevention".)
The discussion that follows assumes that the patient's illness is severe enough to require hospital admission or to pursue an etiologic diagnosis since specific etiologic diagnosis is usually not sought in otherwise healthy patients with mild respiratory tract infections who are treated symptomatically as outpatients. (See "Respiratory syncytial virus infection: Clinical features and diagnosis", section on 'Diagnosis'.)
Indications for hospitalization in children with bronchiolitis are discussed separately. (See "Bronchiolitis in infants and children: Treatment; outcome; and prevention", section on 'Indications for hospitalization'.)
Outpatient treatment for patients with upper respiratory tract infections, bronchiolitis, or pneumonia who do not have a specific microbiologic diagnosis are discussed separately. (See "Community-acquired pneumonia in children: Outpatient treatment", section on 'Empiric therapy' and "The common cold in children: Management and prevention" and "Bronchiolitis in infants and children: Treatment; outcome; and prevention", section on 'Nonsevere bronchiolitis'.)
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- SUPPORTIVE CARE
- Respiratory support
- Bronchodilators plus corticosteroids
- Hypertonic saline
- - In children
- - In adults
- - Contraindications
- - Adverse effects
- Passive immunotherapy
- Combination therapy
- - Ribavirin and immunotherapy
- - Ribavirin and corticosteroids
- PREGNANT WOMEN
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS