Ribavirin for respiratory syncytial virus lower respiratory tract infection. A systematic overview

Arch Pediatr Adolesc Med. 1996 Sep;150(9):942-7. doi: 10.1001/archpedi.1996.02170340056011.


Objective: To systematically review the evidence evaluating the efficacy of aerosolized ribavirin for the treatment of infants with respiratory syncytial virus lower respiratory tract infection.

Design: A computerized search of MEDLINE from 1975 to the present, a review of the reference lists of each retrieved article, and contact with experts.

Patients: infants with documented respiratory syncytial virus lower respiratory tract infection who were the subjects of 8 double-blind randomized placebo-controlled trials.

Methods: Two independent reviewers assessed study quality and extracted data on the study populations, the drug regimens, and clinically relevant outcome measurements.

Results: Ribavirin does not significantly reduce mortality rate (relative risk [RR] = 0.42, 95% confidence interval [CI] = 0.13, 1.44) or lower the probability of respiratory deterioration (RR = 0.42, 95% CI = 0.16, 1.34) when meta-analysis is used to pool the outcomes of 3 trials, although strong trends in the direction of benefit are present. No study found ribavirin to shorten length of hospitalization. Results on length of ventilation and oxygen supplementation are conflicting.

Conclusions: Use of ribavirin in infants with respiratory syncytial virus lower respiratory tract infection is not supported by evidence of significant benefit. However, previous studies lack sufficient power to rule out a potential reduction in mortality rate or respiratory deterioration. A large randomized controlled trial of ribavirin for ventilated and other high-risk patients is needed.

Publication types

  • Meta-Analysis

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay
  • Oxygen Inhalation Therapy
  • Research Design
  • Respiration, Artificial
  • Respiratory Function Tests
  • Respiratory Syncytial Virus Infections / drug therapy*
  • Respiratory Syncytial Virus Infections / mortality
  • Respiratory Syncytial Virus Infections / physiopathology
  • Respiratory Tract Infections / drug therapy*
  • Respiratory Tract Infections / mortality
  • Respiratory Tract Infections / physiopathology
  • Ribavirin / therapeutic use*
  • Treatment Outcome


  • Antiviral Agents
  • Ribavirin