Ribavirin in RSV in children?

[PokerDoc]

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The DIT guy said the AAP discourages its use in children since there is unproven efficacy and can cause more problems.

I went into a practice block on UW with that in mind and ribavirin ended up being the friggin right answer for RSV in a kid and their logic was.. wellllll this one was REALLY BAD so you can give it, but generally dont.

wtf am i supposed to do with that? lol

Can anyone clear this up for me.. If this shows up on test, and I got ribavirin as an answer, do I just pick it or hope I get 'support therapy' as a choice or something.

 

[drizzt3117]

I'd just roll with ribavirin, it's def indicated for rsv.

 

[knuckles]

He said that it was recent studies showing the harms outweighed the benefits, and it would be better for adults. The UWorld question is probably outdated, and regardless of this, I highly doubt the step would test you on a controversial topic.

 

[PokerDoc]

yeah uptodate doesnt suggest ribavirin either and epocrates says to use Palivizumab

 

[knuckles]

maybe you should take the whole primary preventative approach and put, go back in time and place child in bubble, as your answer.

 

[PokerDoc]

If this was a fill in the blanks test.. i'm pretty sure 50% of us would be dead now

 

[healingpower]

yeah uptodate doesnt suggest ribavirin either and epocrates says to use Palivizumab

FA says use palivizumab to neutralize F proteins in RSV.. so i guess they wont give both choices.. probably give palivizumab or ribavirin.


oh and good luck tomorrow PokerDoc! wish u all the best!

 

[knuckles]

Good luck bro!

 

[PokerDoc]

Correct answer is none of the above: im done studying... here goes nothing.. 🙂

 

[knuckles]

Don't forget to kiss your First Aid before you go into the test

 

[PokerDoc]

Don't forget to kiss your First Aid before you go into the test

haha, how could I ever forget... I might use it over the back side of my head tonight so I can sleep too

 

[PokerDoc]

hah so when I went to toss my goljan book onto the floor as a sign of concession, I guess I was holding it the wrong way and kept about 10 pages with me as the rest of the book went on its merry way...

now if thats not a way to end 6 weeks of studying I dont know what is...

 

[knuckles]

It's a sign to study those 10 pages before you go into the test.

oh, and don't forget the seatbelt information from DIT.

 

[radiodoc99]

Palivizumab (say "pah-lih-VIH-zu-mahb") is a monoclonal antibody that reduces hospitalizations due to RSV infection among children at high-risk for severe disease. It is given in monthly intramuscular injections during the RSV season, which generally lasts from November through March in most locations in the United States.
American Academy of Pediatrics (AAP) Guidelines for Infants and Children at Risk for Severe Illness Due to RSV Infection

According to the AAP1, palivizumab prophylaxis may be considered for the following infants and children

• Infants born at 28 weeks' gestation or earlier during RSV season, whenever that occurs during the first 12 months of life
• Infants born at 29–32 weeks' gestation if they are younger than 6 months of age at the start of the RSV season
• Infants born at 32–35 weeks' gestation who are younger than 3 months of age at the start of the RSV season or who are born during RSV season if they have at least one of the following 2 risk factors: 1) infant attends child care; 2) infant has a sibling younger than 5 years of age
• Infants and children younger than 2 years with cyanotic or complicated congenital heart disease
• Infants and children younger than 2 years who have been treated for chronic lung disease within 6 months of the start of the RSV season.
• Infants born before 35 weeks of gestation who have either congenital abnormalities of the airway or neuromuscular disease that compromises handling of respiratory secretions

Consult the American Academy of Pediatrics Red Book (28th edition, 2009) for more specific and latest recommendations, including the length of prophylaxis.
Others at Risk for Severe Illness Due to RSV Infection

Increasingly, RSV infection is recognized as an important cause of respiratory illness in high-risk adults and the elderly. High-risk adults include those with chronic heart disease, chronic lung disease, or compromised immune systems; the elderly include those 65 or older, particularly if they reside in a long-term care facility or participate in other senior day-care programs.
Reference

1. American Academy of Pediatrics. Respiratory Syncytial Virus. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red Book: 2009 Report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009.