1107 RIBAVIRIN(RIB) THERAPY OF RESPIRATORY SYNCYTIAL VIRUS (RSV) INFECTION IN INFANTS WITH CARDIOPULMONARY DISEASE

Aerosolized Rib has appeared beneficial in the treatment of RSV pneumonia in selected normal infants in a previous study. We have since evaluated Rib therapy of RSV lower respiratory tract infection (LRI) in infants with underlying cardiopulmonary disease to determine its efficacy and safety in such high risk infants. 22 infants with RSV LRI were studied in '83–84 in a randomized double-blind manner to receive aerosolized Rib (12) or placebo (10) (water) An additional 20 infants with life-threatening illness were not randomized, but treated with Rib. 26 infants (10 randomized, 16 non-randomized) had bronchopulmonary dysplasia or congenital heart disease. The 22 randomized infants received Rib or placebo for 21 hrs/d for 3–8days(mean=5d) and were matched in age (15wks), sex, underlying disease, duration of illness before therapy and severity of illness on admission. At start of therapy Rib infants had greater illness severity scores by double blind exam than placebo pts (p.06). But Rib pts showed faster and greater improvement by d.3 (p 1 month later. In all 42 infants Rib as an aerosol was administered safely & without signs of toxicity. Administration of Rib through a respirator required careful monitoring but was without adverse effect. These findings suggest Rib is beneficial and may be safely administered to infants with cardiopulmonary disease at high risk for severe RSV Infection.