Tribavirin may be helpful

BMJ 1995;310:1065 (22 April)

Letters

Tribavirin may be helpful

EDITOR,--David Isaacs makes no mention of tribavirin in themanagement of bronchiolitis.¹ Despite its limited efficacy,possible toxicity, and expense (three 6 g phials cost poundssterling585) the synthetic nucleoside tribavirin is the onlyspecific antiviral agent licensed for treatment of respiratorysyncytial virus infection (the main cause of bronchiolitis)and merits further discussion.

Double blind trials of aerosolised tribavirin for lower respiratorytract infection with respiratory syncytial virus have shownsome clinical benefit in normal and high risk infants but conflictingand disputed results in normal and high risk infants receivingassisted ventilation.² ³ ⁴ No important side effects were observed.While no trial has shown that aerosolised tribavirin reducesthe likelihood of intubation or death or gives long term benefit,recent American guidelines recommend its use for the followinggroups in hospital with lower respiratory tract infection withrespiratory syncytial virus: infants at high risk because ofunderlying chronic disease . . . [Full text of this article]