Treating acute bronchiolitis associated with RSV

Treatment for infants with bronchiolitis caused by respiratory syncytial virus (RSV) includes supplemental oxygen, nasal suctioning, fluids to prevent dehydration, and other supportive therapies. High-risk children who should be hospitalized include those younger than three months and those with a preterm birth, cardiopulmonary disease, immunodeficiency, respiratory distress, or inadequate oxygenation. Inhaled beta2-agonist bronchodilators, the anticholinergic agent ipratropium bromide, and nebulized epinephrine have not been shown to be effective for treating RSV bronchiolitis. However, the Agency for Healthcare Research and Quality states that nebulized epinephrine and nebulized ipratropium bromide are possibly effective. The appropriate use of corticosteroids remains controversial. They may provide some benefit but meta-analyses of clinical trial results are inconsistent. Prophylaxis with RSV intravenous immune globulin or palivizumab, a human monoclonal antibody, can reduce hospitalization rates in high-risk patients, although difficulties with administering the medications and high costs may preclude their widespread use. The use of common infection-control measures can reduce nosocomial transmission of RSV infections.