{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T20:47:58Z","timestamp":1785185278335,"version":"3.55.0"},"reference-count":24,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1997,3,1]]},"abstract":"<jats:p>Objectives.\u2003To determine the relationship between receipt of aerosolized ribavirin and the hospital course of high-risk infants and children with respiratory syncytial virus (RSV) lower respiratory infection (LRI).<\/jats:p><jats:p>Methods.\u2003The 1993\u20131994 Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) RSV database consists of prospectively enrolled children with acute RSV LRI, admitted to nine Canadian pediatric tertiary care centers. After excluding cases with compromised immunity and\/or nosocomial infection, subsets with any congenital heart disease (CHD), chronic lung disease (CLD), age \u22646 weeks (INFANT), gestation \u226436 weeks (PREM), or severe disease within 48 hours of admission as shown by an oxygen saturation \u226490% or an FiO2 requirement of &amp;gt;.35 (EARLY HYPOXIA) were studied in two ways. First, each risk group subset was analyzed separately to assess the association between ribavirin receipt and measures of disease severity including duration of intensive care, mechanical ventilation, hy- poxia and RSV-attributable hospital stay. Secondly, ribavirin was added as an independent variable to a previously described multiple regression model for RSV-attributable length of hospital stay and two mutually exclusive subsets were analyzed: 1) previously healthy patients with \u22651 of: INFANT, PREM, or EARLY HY- POXIA; 2) patients with CHD and\/or CLD.<\/jats:p><jats:p>Results.\u2003Between January 1993 and June 1994, 1425 community-acquired hospitalized cases of RSV LRI were entered into the RSV database. Among these 750 (52.6%) fit into one or more of the defined subsets including 97 CHD, 134 CLD, 213 INFANT, 211 PREM, and 463 EARLY HYPOXIA. The proportion ventilated in each group was 20.6%, 20.9%, 15.5%, 15.2%, and 13.3%, respectively. Across the subsets ribavirin use ranged from 36% to 57% of ventilated patients and 6% to 39% of nonventilated patients. For nonventilated patients in each subset the median RSV-attributable hospital length of stay (RSV-LOS) was 2 to 3 days longer for ribavirin recipients and the duration of hypoxia was significantly increased. Duration of intensive care unit (ICU) stay was also increased for all ribavirin-treated subgroups except those with CHD. In contrast, for ventilated patients, ribavirin therapy was not significantly associated with any of the outcome measures regardless of risk group. In the multiple regression model, ribavirin was significantly associated with a prolonged RSV-LOS both for children with CHD and\/or CLD as well as for those whose only risk factors included INFANT, PREM, and\/or EARLY HY- POXIA.<\/jats:p><jats:p>Conclusions.\u2003These data raise further doubts about the clinical effectiveness of ribavirin in infants and children with risk factors for severe disease. Selection bias, with ribavirin used for sicker children, may have influenced outcome. Nevertheless the long durations of hospitalization, ICU, ventilation, and oxygen supplementation in nonventilated ribavirin recipients stress the need for further randomized trials to assess its efficacy. ribavirin, respiratory syncytial virus, pneumonia, bronchiolitis.<\/jats:p>","DOI":"10.1542\/peds.99.3.e7","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:40:17Z","timestamp":1092440417000},"page":"e7-e7","source":"Crossref","is-referenced-by-count":68,"title":["Does Ribavirin Impact on the Hospital Course of Children With Respiratory Syncytial Virus (RSV) Infection? An Analysis Using the Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) RSV Database"],"prefix":"10.1542","volume":"99","author":[{"given":"Barbara J.","family":"Law","sequence":"first","affiliation":[{"name":"From the Winnipeg Children\u2019s Hospital and University of Manitoba, Winnipeg, Manitoba; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine E. L.","family":"Wang","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children and University of Toronto, Toronto, Ontario; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noni","family":"MacDonald","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital of Eastern Ontario and University of Ottawa, Ottawa, Ontario; the"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"McDonald","sequence":"additional","affiliation":[{"name":"Montreal Children\u2019s Hospital, and McGill University, Montreal, Quebec;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Dobson","sequence":"additional","affiliation":[{"name":"British Columbia Children\u2019s Hos- pital and University of British Columbia, Vancouver, British Columbia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Boucher","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de l\u2019Universite Laval, Quebec City, Quebec;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Langley","sequence":"additional","affiliation":[{"name":"Izaak Walton Killam Hospital and Dalhousie University, Halifax, Nova Scotia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Robinson","sequence":"additional","affiliation":[{"name":"Children\u2019s Health Centre and the University of Alberta, Edmonton, Alberta; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Alberta Children\u2019s Hospital, and University of Calgary, Calgary, Alberta."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek","family":"Stephens","sequence":"additional","affiliation":[{"name":"Hospital for Sick Children and University of Toronto, Toronto, Ontario; the"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[1997,3,1]]},"reference":[{"key":"2021120819211979500_B1","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1093\/oxfordjournals.aje.a121558","article-title":"Epidemiology of respiratory syncytial virus infection in Washington, DC. 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