Precautions in the Use of Ribavirin at the Children's Hospital

To the Editor: Ribavirin therapy for infections with respiratory syncytial virus (RSV) is increasingly controversial.^1,2 Important concerns have been raised about its efficacy.^{3 4 5} Even the suggestion that ribavirin is efficacious under certain circumstances⁶ has been challenged.⁷ Although ribavirin can be safely administered through a ventilator,⁸ there is more doubt about its efficacy when administered through an endotracheal tube than when administered as an open aerosol, and endotracheal-tube administration is not recommended.⁹ The controversy has been fueled by recent data suggesting that ribavirin may pose a risk to health care workers.^10,11 Ribavirin administration at the Children's Hospital has for several years…