Intravenous palivizumab and ribavirin combination for respiratory syncytial virus disease in high-risk pediatric patients
Intravenous palivizumab and ribavirin combination for respiratory syncytial virus disease in high-risk pediatric patients
复制标题
DOI：
10.1097/inf.0b013e3181343b7e
复制
发表时间：
2007-12-01
影响因子：
3.6
通讯作者：
Ramilo, Octavio
中科院分区：
文献类型：
--
作者：
Chavez-Bueno, Susana;Mejias, Asuncion;Ramilo, Octavio
背景资料：严重呼吸道合胞病毒（RSV）疾病的风险因素包括早产、先天性心脏病、慢性肺病和免疫功能低下状态。对于高危患者中重度RSV感染的最有效治疗方法尚无共识。帕利珠单抗被批准用于预防RSV疾病，利巴韦林被批准用于治疗RSV感染，但其在高危患者中的疗效尚未最终确定。方法：回顾性分析2001年至2005年在儿科医院接受静脉注射帕利珠单抗和利巴韦林治疗的RSV感染儿童的病历。2001年10月至2005年7月，因RSV感染住院的20例男性和11例女性患者（中位年龄为23.4个月）接受了帕利珠单抗静脉给药治疗。平均剂量为14.93（SD = 0.68）mg/kg。25名患者（80%）也接受了利巴韦林，其中22人通过雾化。常见的基线诊断为恶性肿瘤（n = 15）、先天性心脏病（n = 5）和早产（n = 5）。包括1例心脏移植受者和6例造血干细胞移植受者。18例（58%）患者出现下呼吸道感染体征，17例出现低氧血症，10例需要入住重症监护室（ICU），5例插管。存活29例（93.6%），死亡2例。没有不良事件归因于静脉注射帕利珠单抗或利巴韦林administrationwere observed.Conclusions：治疗RSV感染的高危儿童静脉注射帕利珠单抗单独或与利巴韦林相结合的耐受性良好，并与死亡率降低与以前的报告相比。
Background: Risk factors for severe respiratory syncytial virus (RSV) disease include prematurity, congenital heart disease, chronic lung disease, and immunocompromised states. There is no consensus concerning the most effective therapy for severe RSV infection in high-risk patients. Palivizumab is approved for prevention of RSV disease, and ribavirin is approved for treatment of RSV infections but its efficacy in high-risk patients has not been conclusively established.Methods: Retrospective chart review of RSV infected children treated with intravenous palivizumab and ribavirin in a pediatric hospital from 2001 to 2005.Results: Twenty male and 11 female patients with a median age of 23.4 months, hospitalized for RSV infection were treated with intravenous palivizumab from October 2001 through July 2005. Mean dose was 14.93 (SD = 0.68) mg/kg. Twenty-five patients (80%) also received ribavirin, 22 of whom by aerosolization. Common baseline diagnoses were malignancy (n = 15), congenital heart disease (n = 5), and prematurity (n = 5). Included above are 1 cardiac and 6 hematopoietic stem cell transplant recipients. Eighteen (58%) patients had signs of lower respiratory tract infection, 17 were hypoxemic, 10 required intensive care unit (ICU) admission, and 5 were intubated. Twenty-nine (93.6%) patients survived and 2 died. No adverse events attributed to intravenous palivizumab or ribavirin administration were observed.Conclusions: Treatment of RSV-infected high-risk children with intravenous palivizumab alone or in combination with ribavirin was well tolerated and associated with decreased mortality compared with previous reports.