Ribavirin Aerosol in the Elderly

Liss, Howard P.; Bernstein, Jack

doi:10.1378/chest.93.6.1239

Cited by 27 publications

(15 citation statements)

References 10 publications

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“…No formal recommendations on its use may be made at this time, given the limited safety and efficacy data of ribavirin therapy in elderly adults [33]. Currently, there are two immunoglobulin preparations that are licensed for prophylaxis of RSV infections: a polyclonal anti-RSV IgG (RSV IVIG) and the humanized monoclonal antibody palivizumab, which recognizes an epitope on the RSV F protein and is currently licensed only for use in high-risk infants [34].…”

Section: Treatment Of Respiratory Syncytial Virus Infection In Adultsmentioning

confidence: 99%

Respiratory syncytial virus infection in adults

Murata¹

2008

Current Opinion in Pulmonary Medicine

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Section: Treatment Of Respiratory Syncytial Virus Infection In Adultsmentioning

confidence: 99%

Respiratory syncytial virus infection in adults

Murata¹

2008

Current Opinion in Pulmonary Medicine

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“…For ease of administration and improved compliance, shorter durations of therapy with higher concentrations of the drug have been investigated. 13,14 In unintubated children, high-dose short-duration aerosolized ribavirin (6 g/day delivered at a concentration of 60 mg/ml for 2 h every 8 h) has been demonstrated to be safe and to have similar antiviral effects as the standard regimens. 14 This regimen has also been found to be safe in elderly persons with chronic obstructive lung disease.…”

mentioning

confidence: 99%

“…14 This regimen has also been found to be safe in elderly persons with chronic obstructive lung disease. 13 We conducted a pilot trial of combination therapy with aerosolized ribavirin and intravenous immunoglobulin (IVIG) for RSV upper respiratory tract illnesses in adult BMT recipients with the goal of preventing progression to pneumonia and death. Ribavirin was combined with IVIG because studies in vitro, in animal models, and in children had suggested that immunoglobulin may be of benefit for RSV infections prophylactically as well as therapeutically.…”

mentioning

confidence: 99%

Respiratory syncytial virus upper respiratory tract illnesses in adult blood and marrow transplant recipients: combination therapy with aerosolized ribavirin and intravenous immunoglobulin

Ghosh

Champlin

Englund

et al. 2000

Bone Marrow Transplant

184

123

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Summary:Respiratory syncytial virus (RSV) is an important cause of serious respiratory illness in blood and marrow transplant (BMT) recipients. In some subsets of these immunocompromised patients, RSV upper respiratory illnesses frequently progress to fatal viral pneumonia. The frequency of progression to pneumonia is higher during the pre-engraftment than during the postengraftment period. Once pneumonia develops, the overall mortality is 60-80%, regardless of the treatment strategy. We performed a pilot trial of therapy of RSV upper respiratory illnesses using aerosolized ribavirin and IVIG (500 mg/kg every other day), with the goal of preventing progression to pneumonia and death. Two dosages of ribavirin were used: a conventional regimen (6 g/day at 20 mg/ml for 18 h/day) and a high-dose short-duration regimen (6 g/day at 60 mg/ml for 2 h every 8 h). Fourteen patients were treated for a mean of 13 days (range: 7-23 days). In 10 (71%) patients, the upper respiratory illness resolved. The other four (29%) patients, three of whom were in the pre-engraftment period, developed pneumonia, which was fatal in two. The most common adverse effect was psychological distress at being isolated within a scavenging tent. In conclusion, prompt therapy of RSV upper respiratory illnesses in BMT recipients with a combination of aerosolized ribavirin and IVIG was a safe and promising approach to prevent progression to pneumonia and death. Bone Marrow Transplantation (2000) 25, 751-755. Keywords: respiratory; syncytial; virus; therapy; ribavirin; transplant Respiratory syncytial virus (RSV) is a frequent cause of acute respiratory illness in autologous as well as allogeneic blood and marrow transplant (BMT) recipients. 1-11 These infections usually occur during community outbreaks, which typically occur in a seasonal fall-winter pattern. In

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“…This agent is a guanosine analog with broad antiviral properties (69). Experience with this agent in adults is limited, although it has been administered safely to elderly patients (132). Several other anti-RSV agents interfere with RNA, and small-molecule fusion inhibitors are under active development (69).…”

Section: Pathogen-specific Therapymentioning

confidence: 99%

Pathogen-directed Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Martínez

2007

Proceedings of the American Thoracic Society

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Acute exacerbations of chronic obstructive pulmonary disease (COPD) are important events in the natural history of this chronic lung disorder. These events can be caused by a large number of infectious and noninfectious agents and are associated with an increased local and systemic inflammatory response. Their frequency and severity have been linked to progressive deterioration in lung function and health status. Infectious pathogens ranging from viral to atypical and typical bacteria have been implicated in the majority of episodes. Most therapeutic regimens to date have emphasized broad, nonspecific approaches to bronchoconstriction and pulmonary inflammation. Increasingly, therapy that targets specific etiologic pathogens has been advocated. These include clinical and laboratory-based methods to identify bacterial infections. Further additional investigation has suggested specific pathogens within this broad class. As specific antiviral therapies become available, better diagnostic approaches to identify specific pathogens will be required. Furthermore, prophylactic therapy for at-risk individuals during high-risk times may become a standard therapeutic approach. As such, the future will likely include aggressive diagnostic algorithms based on the combination of clinical syndromes and rapid laboratory modalities to identify specific causative bacteria or viruses.

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Ribavirin Aerosol in the Elderly

Cited by 27 publications

References 10 publications

Respiratory syncytial virus infection in adults

Respiratory syncytial virus infection in adults

Respiratory syncytial virus upper respiratory tract illnesses in adult blood and marrow transplant recipients: combination therapy with aerosolized ribavirin and intravenous immunoglobulin

Pathogen-directed Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

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