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Antifungal Drugs |   |
Ribavirin
The antiviral drug Ribavirin (Virazole) is active against respiratory syncytial virus (RSV), influenza virus, and herpes simplex virus. It has been approved as an inhaled aerosol for treating some infants and children who have, or are at increased risk for, severe lower respiratory tract infections caused by RSV. The American Academy of Pediatrics' recommendations for using Ribavirin include:
For use to treat patients hospitalized with RSV lower respiratory tract disease, at high risk for severe/complicated RSV infection caused by the following:
- complicated congenital heart disease
- bronchopulmonary dysplasia, cystic fibrosis, or other chronic lung conditions
- premature infants
- those with immunodeficiency
- recent transplant recipients
- those receiving chemotherapy for malignancy
- infants who are severely ill (PaO2 <65 torr, SaO2 <90%, increasing PaCO2)
- patients on mechanical ventilation for RSV infection
- hospitalized infants at increased risk of progressing from mild to complicated course because of young age or underlying condition
Ribavirin is supplied as a powder of 6 grams per 100 ml vial. Sterile H20 is injected into the vial to achieve a concentration of 20 mg/ml (final total volume for administration is 300 ml). The mixture is good for 24 hours and then must be discarded. It is administered through a small particle aerosol generator (SPAG). The aerosol is delivered into an 02 hood, tent, or ventilator circuit.
Treatment with Ribavirin is usually for 12-18 hours per day for 3-7 days, and the package insert instructions should be consulted for more complete information. Side effects commonly seen include pulmonary function deterioration, and skin irritation from excess drug precipitation.