Recent advances in the management and prophylaxis of respiratory syncytialvirus infection

Respiratory syncytial virus (RSV) infection is an important cause of morbid ity, particularly in prematurely born infants who have had chronic lung dis ease. Current therapy is essentially supportive. Overall, the results of ra ndomized trials do not support the use of bronchodilators, corticosteroids or Ribavirin. Nitric oxide and exogenous surfactant may improve the respira tory status of those infants who require ventilatory support. Nosocomial in fection can be reduced by appropriate handwashing. There is no safe and eff ective vaccine for use in infants. Immunoprophylaxis reduces hospitalizatio n and requirement for intensive care. Palivizumab, a humanized monoclonal a ntibody, is preferred to RSV immune globulin as the immunoprophylactic agen t. Immunoprophylaxis should be reserved for infants at highest risk of seve re respiratory syncytial virus infection. if this strategy is to be used mo st cost-effectively.