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2016 ; 18
(2
): 210-5
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Current practices for treatment of respiratory syncytial virus and other
non-influenza respiratory viruses in high-risk patient populations: a survey of
institutions in the Midwestern Respiratory Virus Collaborative
#MMPMID26923867
Beaird OE
; Freifeld A
; Ison MG
; Lawrence SJ
; Theodoropoulos N
; Clark NM
; Razonable RR
; Alangaden G
; Miller R
; Smith J
; Young JA
; Hawkinson D
; Pursell K
; Kaul DR
Transpl Infect Dis
2016[Apr]; 18
(2
): 210-5
PMID26923867
show ga
BACKGROUND: The optimal treatment for respiratory syncytial virus (RSV) infection
in adult immunocompromised patients is unknown. We assessed the management of RSV
and other non-influenza respiratory viruses in Midwestern transplant centers.
METHODS: A survey assessing strategies for RSV and other non-influenza
respiratory viral infections was sent to 13 centers. RESULTS: Multiplex
polymerase chain reaction assay was used for diagnosis in 11/12 centers. Eight of
12 centers used inhaled ribavirin (RBV) in some patient populations. Barriers
included cost, safety, lack of evidence, and inconvenience. Six of 12 used
intravenous immunoglobulin (IVIG), mostly in combination with RBV. Inhaled RBV
was used more than oral, and in the post-stem cell transplant population,
patients with lower respiratory tract infection (LRTI), graft-versus-host
disease, and more recent transplantation were treated at higher rates. Ten
centers had experience with lung transplant patients; all used either oral or
inhaled RBV for LRTI, 6/10 treated upper respiratory tract infection (URTI). No
center treated non-lung solid organ transplant (SOT) recipients with URTI; 7/11
would use oral or inhaled RBV in the same group with LRTI. Patients with
hematologic malignancy without hematopoietic stem cell transplantation were
treated with RBV at a similar frequency to non-lung SOT recipients. Three of 12
centers, in severe cases, treated parainfluenza and metapneumovirus, and 1/12
treated coronavirus. CONCLUSIONS: Treatment of RSV in immunocompromised patients
varied greatly. While most centers treat LRTI, treatment of URTI was variable. No
consensus was found regarding the use of oral versus inhaled RBV, or the use of
IVIG. The presence of such heterogeneity demonstrates the need for further
studies defining optimal treatment of RSV in immunocompromised hosts.
|Administration, Oral
[MESH]
|Antiviral Agents/therapeutic use
[MESH]
|Data Collection
[MESH]
|Humans
[MESH]
|Immunocompromised Host
[MESH]
|Immunoglobulins, Intravenous/*therapeutic use
[MESH]