Antiviral therapy in neonatal chronic lung disease.
Infants born prematurely who develop chronic lung disease frequently suffer acute respiratory deteriorations. In a randomized trial, we assessed if treatment of such relapses with the antiviral agent Ribavirin increased the speed of recovery and improved lung function at follow-up. 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 for 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 identified in relatively few patients, the interim analysis demonstrated Ribavirin administration for 3 days was associated with a greater reduction in respiratory rate and inspired oxygen concentration (P < 0.02). At follow-up, there was no significant difference between groups in the 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 conductance (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 lung function, but not lower respiratory morbidity, at follow-up.
Giffin
F J
FJ
Department of Child Health, King's College Hospital, London, UK.
Greenough
A
A
Yüksel
B
B
D000280:Administration, Inhalation; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008168:Lung / Q000187:drug effects / Q000502:physiology / Q000821:virology; D008171:Lung Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D012119:Respiration / Q000502:physiology; D012129:Respiratory Function Tests; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*
D000998:Antiviral Agents; D012254:Ribavirin