Carmack M A, Prober C G
Department of Pediatrics, Stanford University School of Medicine, California.
Infect Agents Dis. 1992 Apr;1(2):99-107.
Respiratory syncytial virus is the major respiratory pathogen in infants and young children. Every year, this unique and ubiquitous virus accounts for substantial morbidity and occasional mortality in this age group. Until recently, therapy for respiratory syncytial virus infections was limited to supportive measures such as hydration, supplemental oxygen, and assisted ventilation. Therefore, the licensure of ribavirin in 1986 for treatment of respiratory syncytial virus infections raised hopes for specific and effective therapy. However, the use of ribavirin has been the subject of continuing controversy and debate. Despite at least eight controlled clinical trials involving collectively over 170 patients treated with ribavirin since 1983, no clear consensus has developed regarding which patients should be treated with ribavirin. Major issues are weaknesses in the design and methodology of studies that claim treatment efficacy, the clinical significance of the demonstrated treatment effects, potential teratogenicity to health care workers exposed to aerosolized ribavirin, and cost-effectiveness of the intervention. This review will explore each of these areas of controversy and consider the unanswered questions to which future research must be directed.
呼吸道合胞病毒是婴幼儿的主要呼吸道病原体。每年，这种独特且普遍存在的病毒在该年龄组中导致大量发病，并偶尔造成死亡。直到最近，呼吸道合胞病毒感染的治疗仍局限于支持性措施，如补液、补充氧气和辅助通气。因此，1986年利巴韦林被批准用于治疗呼吸道合胞病毒感染，为特异性和有效治疗带来了希望。然而，利巴韦林的使用一直存在争议和辩论。自1983年以来，尽管至少有八项对照临床试验，总共涉及170多名接受利巴韦林治疗的患者，但对于哪些患者应该接受利巴韦林治疗尚未形成明确的共识。主要问题包括声称有治疗效果的研究在设计和方法上存在缺陷、已证明的治疗效果的临床意义、接触雾化利巴韦林的医护人员潜在的致畸性以及干预措施的成本效益。本综述将探讨这些争议领域中的每一个，并考虑未来研究必须针对的未解决问题。
