The effect of ribavirin to treat previously healthy infants admitted with acute bronchiolitis on acute and chronic respiratory morbidity

The role of ribavirin in the treatment or acute bronchiolitis is controvers ial. It has been suggested that the use of ribavirin mag. be of benefit dur ing the acute illness and may reduce subsequent recurrent respiratory morbi dity. This randomized, double-blind, placebo-controlled study was designed to determine whether ribavirin administered during the acute illness would have an influence on respiratory morbidity during both the acute illness an d during the following year. Bronchial reactivity 6 months after the acute illness was also assessed. Forty previously well infants with moderately se vere acute bronchiolitis M ere recruited during three winter epidemics. Sub jects received study medication for 18 h a day. Management was otherwise un altered. Subjects were evaluated daily by the investigator and subsequently assessed at 6 weeks, 6 months and year following the acute illness. Assess ment of bronchial hyper-responsiveness was assessed at 6 months of age usin g total body plethysmography and an established ultra-sonically nebulized d istilled water challenge. A total of 40 patients (21 ribavirin, 19 placebo) were entered into the stu dy. The two groups did not differ with respect to age, gender or clinical s everity on entry to the trial. No significant differences were identified i n the rate of clinical improvement over the first 24 h. the time to dischar ge, bronchial responsiveness at 6 months of age, frequency of significant r espirator?; symptoms over the first year of life and the frequency of presc ribed bronchodilators and inhaled steroids during the year of follow-up. Th is study was unable to demonstrate any clinical benefit from the use of rib avirin in the acute illness or during subsequent follow-up for 1 year. (C) 2001 HARCOURt PuBLISHERS LTD.