Treatment:
- Mostly supportive care
- Ribavirin – only in select patients (complicated congenital heart disease, chronic lung disease, bronchopulmonary dysplasia, immunocompromised patients)
- Beta-agonists or race epinephrine – not usually used
- Corticosteroids, hypertonic saline or antibiotics are also not usually used.
Prophylaxis:
- Palivizumab: 15 mg/kg/dose; prophylaxis is not recommended if > 29 weeks gestation (risk factors not considered)
- Neonates born at less than 29 weeks may get prophylaxis during their 2nd RSV season too. Not based on history alone.
- Discontinue prophylaxis if hospitalized.
- Other factors:
- Lung disease requiring 21% oxygen or more in 1st 28 days (consider prophylaxis for a second season if lung disease within 6 months of season start)
- Congenital heart disease that will require surgery, but surgery not yet performed
- Pulmonary HTN, congenital abnormalities of airway, neuromuscular disease or immunocompromised.