FOLLOW-UP OF CHILDREN WITH RESPIRATORY SYNCYTIAL VIRUS BRONCHIOLITIS IN 1986 AND 1987 - POTENTIAL EFFECT OF RIBAVIRIN ON LONG-TERM PULMONARY-FUNCTION

Background, Hospitalization for respiratory syncytial virus (RSV) bron chiolitis is considered a risk factor for reactive airway disease and/ or abnormal pulmonary function tests (PFTs) later in childhood, This s tudy attempted to assess this observation with newer PFTs and to deter mine whether ribavirin therapy of initial RSV infection may affect the long term outcome, Methods, Medical records of all infants hospitaliz ed with RSV infection in 1986 and 1987 at six institutions (North Shor e University Hospital, Children's Hospital of Buffalo, University Flor ida-Gainesville, University of Connecticut, Children's Hospital Nation al Medical Center, Denver Children's Hospital) were requested, Patient s who could be contacted were recalled in 1993 and 1994 for PFTs and g iven a pulmonary status questionnaire, Results, One hundred patients w ere evaluated. Overall PFTs were within normal ranges, There was less ''bronchitis'' over the interval years in the ribavirin-treated patien ts (13 of 33) vs, those who did not receive ribavirin (44 of 67, P < 0 .01), There was no difference for the diagnosis of reactive airway dis ease (15 of 33 ribavirin vs, 36 of 67 no ribavirin), Patients who rece ived ribavirin were then matched by age (within 2 weeks) at initial RS V infection and underlying risk factor (bronchopulmonary dysplasia, he art disease), Of the 27 patients matched, the ribavirin patients had l onger intensive care unit stays (median (25 to 75% interquartile range ): 2 (0 to 7) vs, 0 (0 to 0), P < 0.05), On follow-up evaluation there were no significant differences in PFTs or reactive airway disease be tween the 2 groups, There was a trend toward lower forced expiratory v olume at 1 s and midexpiratory flow rate (25 to 75%) in the ribavirin- treated group, and there were more reported pneumonias on follow-up in the ribavirin patients, Conclusion, During our 5- to 6- year follow-u p of children, status post bronchiolitis, we noted a good long term pr ognosis. No long term adverse effects on pulmonary function were detec ted, Despite being potentially sicker at presentation as assessed by i ntensive care unit stay, ribavirin recipients were doing equally well at the time of follow-up.