The role of RSV neutralizing antibodies in the treatment and prevention of respiratory syncytial virus infection in high-risk children.

Studies assessing the use of RSV immune globulin in the treatment of RSV illness are not yet completed. However, a large multicenter trial demonstrated that prophylaxis with RSV immune globulin was safe and efficacious in prevention of serious RSV disease in high-risk infants. Refinements in the practical application of RSVIG are needed, as intravenous lines are difficult to place and maintain in these fragile infants. With the development of concentrated polyclonal and/or effective monoclonal antibody preparations, it may be possible to immunize intramuscularly (Tempest et al., 1993; Barbas et al., 1992). The efficacy of RSV-specific monoclonal antibodies must still be defined, and the appropriate viral epitopes targeted. While these issues still need to be addressed, it is exciting to have finally produced a safe and effective way to prevent severe RSV disease in high-risk young children.