title: An adaptive randomized trial of an intermittent dosing schedule of aerosolized ribavirin in patients with cancer and respiratory syncytial virus infection.
abstract: A continuous dosing schedule of aerosolized ribavirin has been used for respiratory syncytial virus (RSV) upper respiratory tract infection and lower respiratory tract infection (LRTI) but is associated with high cost and inconvenient administration. We conducted an adaptive randomized trial to evaluate the effectiveness of an intermittent dosing schedule of ribavirin versus that of a continuous dosing schedule of ribavirin in preventing RSV LRTIs in 50 hematopoietic stem cell transplant recipients or patients with hematologic malignancies. LRTI occurred in 3 patients (9%) receiving the intermittent schedule and in 4 (22%) receiving the continuous schedule, with a 0.889 posterior probability. Because the intermittent schedule is easy to administer and has a higher efficacy than the continuous schedule, we recommend the intermittent schedule for patients who are at risk for RSV LRTI. Clinical Trials Registration. NCT00500578.
authors.affiliation: Department of Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. rfchemaly@mdanderson.org
authors.forename: Roy F
authors.initials: RF
authors.lastname: Chemaly
authors.forename: Harrys A
authors.initials: HA
authors.lastname: Torres
authors.forename: Mark F
authors.initials: MF
authors.lastname: Munsell
authors.forename: Dimpy P
authors.initials: DP
authors.lastname: Shah
authors.forename: Dhanesh B
authors.initials: DB
authors.lastname: Rathod
authors.forename: Gerald P
authors.initials: GP
authors.lastname: Bodey
authors.forename: Chitra
authors.initials: C
authors.lastname: Hosing
authors.forename: Chadi
authors.initials: C
authors.lastname: Saifan
authors.forename: Issam I
authors.initials: II
authors.lastname: Raad
authors.forename: Richard E
authors.initials: RE
authors.lastname: Champlin
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000336:Aerosols / Q000008:administration & dosage*; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D018357:Respiratory Syncytial Virus Infections / Q000188:drug therapy*; D018113:Respiratory Syncytial Virus, Human / Q000302:isolation & purification*; D012141:Respiratory Tract Infections / Q000188:drug therapy*; D012254:Ribavirin / Q000008:administration & dosage*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000336:Aerosols; D000998:Antiviral Agents; D012254:Ribavirin