October 30, 2012

Oral versus inhaled ribavirin therapy for respiratory syncytial virus infection after lung transplantation.


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RSV leads to significant morbidity in transplant patients. In lung transplants, respiratory virus infections are associated with acute rejection and bronchiolitis obliterans syndrome. Most experts treat RSV with ribavirin although the best route of ribavirin administration is unknown. In this study, the authors compare oral and inhaled routes of ribavirin administration in 21 lung transplant patients with RSV. The patient groups were well-matched. However, no differences were seen in progression to BOS regardless of route of ribavirin administration. This is an important finding since there is great variation in centers with regards to route of administration. There are logistical issues in administering inhaled ribavirin (eg the need for a negative pressure room) whereas there may be limitations to the availability of oral ribavirin for RSV. It is important to note that the study is retrospective and sample size may be too small to detect differences in clinical outcomes. Nevertheless, it provides important information in an area where treatment options are limited.

Transplant Infectious Disease

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