Iowa Neonatology Handbook: Infection

Management of Infants with RSV (Respiratory Syncytial Virus) Infection

Edward F. Bell, MD
Peer Review Status: Internally Peer Reviewed

RSV infection causes bronchiolitis and pneumonia in infants. Morbidity is high in infants with chronic pulmonary disease or congenital heart disease. RSV infection can be quickly diagnosed in the virology laboratory, by rapid antigen testing on a nasopharyngeal swab. A respiratory panel culture can also diagnose RSV. Infants hospitalized with RSV should be placed in strict isolation. Infants who are at high risk for significant morbidity and/or mortality should be identified and treated prophylactically.

Two prophylactic therapies are available:

• RespiGam™ is RSV immunoglobulin that also may afford protection against other viral pathogens. It requires intravenous administration over 3-4 hours every 4 weeks. Hence, its use is limited to infants with evidence of more severe chronic lung disease. See "Guidelines for Immunoprophylaxis against RSV".
• Synagis™ is RSV monoclonal antibody that is specific against RSV. It requires intramuscular injections every 4 weeks. It should be considered for preterm infants without evidence of significant chronic lung disease. See "Guidelines for Immunoprophylaxis against RSV".

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