ANTIVIRAL THERAPY IN NEONATAL CHRONIC LUNG-DISEASE

Infants born prematurely who develop chronic lung disease frequently s uffer acute respiratory deteriorations. In a randomized trial, we asse ssed if treatment of such relapses with the antiviral agent Ribavirin increased the speed of recovery and improved lung function at follow-u p. During the acute deterioration and its treatment, respiratory rate and requirement for respiratory support were recorded. Once discharged from hospital, respiratory symptoms and admissions for chest-related illnesses were documented: Infants were recalled at 6 months of age fo r lung function measurements. Forty-four infants (23 given Ribavirin), median gestational age of 26 weeks, completed the trial and had lung function measurements at 6 months. Although viral infections were iden tified in relatively few patients, the interim analysis demonstrated R ibavirin administration for 3 days was associated with a greater reduc tion in respiratory rate and inspired oxygen concentration (P < 0.02). At follow-up, there was no significant difference between groups in t he proportion of infants who were symptomatic or required re-admission to hospital for chest-related illnesses; the Ribavirin group, however , had lower airways resistance (P < 0.01) and higher specific conducta nce (P < 0.02). We conclude that antiviral therapy seems to speed the rate of recovery from acute respiratory deteriorations seen in preterm infants with chronic lung disease; this is associated with improved l ung function, but not lower respiratory morbidity, at follow-up.