Antibiotic Shown Effective Also Against Viral Infection (Bronchiolitis)

Antibiotic Shown Effective Also Against Viral Infection(Bronchiolitis)

RSV(respiratory syncytial virus) is the most common respiratory pathogen in infants and young children. It has infected nearly all infants by the age of two years. Seasonal outbreaks of acute respiratory illness occur each year, on a schedule that is somewhat predictable in each region. The season typically begins in the fall and runs into the spring.


RSV is spread easily by physical contact. Touching, kissing, and shaking hands with an infected person can spread RSV. Transmission is usually by contact with contaminated secretions, which may involve tiny droplets, or objects that droplets have touched. RSV can live for half an hour or more on hands. The virus can also live up to five hours on countertops and for several hours on used tissues. RSV often spreads very rapidly in crowded households and day care centers.

Researchers suggest that because there's less humidity in the air at higher altitudes, it may make it harder for infants and young children to clear mucus and respiratory secretions from the lungs, which may lead to congestion and increased rates of infection. The lower oxygen levels in the air at high altitudes may also contribute to breathing difficulties in children with lung infections.

According to the results of this study, children living at high altitudes may have an increased risk of developing severe RSV. RSV season is typically from late fall through early spring.

In infants and young children, RSV can cause pneumonia , bronchiolitis (inflammation of the small airways of the lungs), and croup . In healthy adults and older children, RSV is usually a mild respiratory illness. Although studies have shown that people produce antibodies against the virus, infections continue to occur in people of all ages.

Bronchiolitis is an infection of the lungs' airways. It most often occurs in young children, commonly between 3 and 6 months of age. About one in nine babies gets bronchiolitis in his or her first year of life, usually during the fall and winter months.Bronchiolitis starts out with signs and symptoms similar to those of a common cold but then progresses to coughing and wheezing.

Although a child's bout of bronchiolitis may be scary, particularly for parents, signs and symptoms typically last for about a week and then go away. In the meantime, you can take a number of self-help measures to make your child more comfortable.

Fortunately, most cases of bronchiolitis are mild and require no specific professional treatment. It is belived that antibiotics aren't useful for treating bronchiolitis because it's caused by a viral infection, and antibiotics are only effective against bacterial infections.

But recently,a new research shown that infants with bronchiolitis caused by RSV (respiratory syncytial virus), may benefit from treatment with an antibiotic.

Usually occurring in winter, bronchiolitis is the most common respiratory ailment affecting children under two years of age. The virus RSV is the usual cause and treatment has been largely supportive, consisting of supplemental oxygen, intravenous fluids and use of a ventilator if needed. In cases of viral illnesses such as RSV, antibiotics are typically not given.

But because RSV initiates an immune reaction that fuels lung inflammation that may produce long-lasting harmful effects, the Turkish team hypothesized that the course of the disease could be modified and wheezing after bronchiolitis prevented by early treatment with clarithromycin, an antibiotic with anti-inflammatory effects.

To test their hypothesis, Dr. Fulya Tahan and colleagues from Erciyes University School of Medicine, Kayseri, treated 21 infants with RSV bronchiolitis with clarithromycin or inactive placebo for 3 weeks.

They found that children treated with clarithromycin spent significantly less time in the hospital (51 hours vs 88 hours with placebo). Time on supplemental oxygen, intravenous therapy, and bronchodilator therapy was also reduced in the antibiotic arm.

Infants who received the antibiotic were also much less likely to be readmitted to the hospital within 6 months of discharge.

Significant decreases in plasma levels of key inflammatory markers were evident after three weeks of clarithromycin.

"Clarithromycin may be helpful in reducing the short-term effects of RSV bronchiolitis, (which) could be important in reducing subsequent morbidity," the authors conclude.

"The present study should encourage further studies to confirm the use of clarithromycin in RSV bronchiolitis, especially in infants less than 6 months of age," they note.

Home Treatment

The best treatment for most children is time to recover and plenty of fluids. Making sure a child drinks enough fluids can be a tricky task, however, because infants with bronchiolitis may not feel like drinking. Therefore, the child should be offered fluids in small amounts at more frequent intervals than usual.

To make breathing easier, many parents use a cool-mist vaporizer during the winter months to keep the air in the child's room moist; dry winter air can dry out airways and make the mucus stickier. Avoid hot-water and steam humidifiers, which can be hazardous and can cause scalding. If you use a cool-mist humidifier, clean it daily with household bleach to discourage mold.

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