Palivizumab is a shot that can help protect certain infants and children 2 years old and younger who are at high risk of serious complications from RSV. It’s typically given once a month during the RSV season. Palivizumab is not a vaccine, and it cannot cure or treat a child who is already diagnosed with RSV.
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Beyfortus (nirsevimab) is approved for the prevention of RSV in newborns and babies born during or entering their first RSV season and in children up to 24 months who are at risk for severe RSV disease during their second RSV season. Beyfortus is a shot given once before or during the RSV season.
Bronchiolitis is the leading cause of hospitalization in infants and young children. Since there is no cure for bronchiolitis, treatment is primarily aimed at alleviating symptoms of fever and breathing difficulties. If hospitalization is required, the treatment may also include supplemental oxygen and intravenous fluids to prevent dehydration.
While it would seem reasonable to use albuterol in cases of severe bronchiolitis, updated guidance from the American Academy of Pediatrics (AAP) now recommends against its use.
Why the AAP Advises Against Albuterol
In their updated 2014 recommendations, the AAP acknowledged that albuterol can provide transient relief in children with bronchiolitis in the same way that it does asthma. However, the actual effectiveness of the drug in this scenario was largely subjective.
Research published in 2013 has shown that the use of albuterol in hospitalized children did nothing to improve outcomes or reduce hospital stays. Moreover, the AAP recommends against other treatments commonly used in the past, including nebulized hypertonic saline, systemic corticosteroids, antibiotics, and chest physiotherapy.
When to Go to the Hospital
Bronchiolitis in children will usually develop after two to three days of the common cold. It typically starts with nasal congestion and discharge, a mild cough, and a fever over 100.4 F.
If the infection progresses and the lower air passages are involved, the condition can become serious and lead to symptoms of:
A parent will know that it’s time to take the child to the emergency room if the wheezing lasts for more than seven days orprogresses to grunting.
Another indication that a trip to the ER is warranted is if a child is using the muscles between the ribs or at the neck to take in breaths, is belly breathing (meaning the belly is going up and down severely with each breath), or cannot complete sentences without taking breaths in-between.
If the child weakens considerably and has a bluish tinge to the skin or lips (cyanosis), the parent should consider it a medical emergency and call 911.
Current Hospital Recommendations
Approximately 2-3% of all children will require hospitalization for bronchiolitis. Treatment involves the monitoring of vital signs and supportive care based on the child’s condition and symptoms.
If the child is unable to eat or drink, either because the respiratory rate is too fast or breathing is severely impaired, fluids and nutrition may need to be delivered intravenously (into a vein).To prevent the spread of the virus, the child would be isolated from siblings and other children until the condition is fully resolved.
Most children hospitalized for bronchiolitis are well enough to return home after three to four days.
Frequently Asked Questions
No, Albuterol is not meant to help withcongestion. Albuterol is a bronchodilator that is used as a treatment for people diagnosed with asthma or COPD. It can help prevent and relieve wheezing, chest tightness, coughing, and trouble breathing.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Pediatrics.Updated guidance: use of palivizumab prophylaxis to prevent hospitalization from severe respiratory syncytial virus infection during the 2022-2023 rsv season.Ralston SL, Lieberthal AS, Meissner HC, et al.Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis.Pediatrics.2014;134(5):e1474-502. doi:10.1542/peds.2014-2742Hall CB, Weinberg GA, Blumkin AK, et al.Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age.Pediatrics.2013;132(2):e341-8. doi:10.1542/peds.2013-0303American Academy of Pediatrics.Bronchiolitis.Øymar K, Skjerven HO, Mikalsen IB.Acute bronchiolitis in infants, a review. Scand J Trauma Resusc Emerg Med. 2014;22:23. doi:10.1186/1757-7241-22-23U.S. Food and Drug Administration.FDA’s Approval of Veklury (Remdesivir) For the Treatment of COVID-19—the Science of Safety and Effectiveness.MedlinePlus.Remdesivir Injection.MedlinePlus.Albuterol.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Pediatrics.Updated guidance: use of palivizumab prophylaxis to prevent hospitalization from severe respiratory syncytial virus infection during the 2022-2023 rsv season.Ralston SL, Lieberthal AS, Meissner HC, et al.Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis.Pediatrics.2014;134(5):e1474-502. doi:10.1542/peds.2014-2742Hall CB, Weinberg GA, Blumkin AK, et al.Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age.Pediatrics.2013;132(2):e341-8. doi:10.1542/peds.2013-0303American Academy of Pediatrics.Bronchiolitis.Øymar K, Skjerven HO, Mikalsen IB.Acute bronchiolitis in infants, a review. Scand J Trauma Resusc Emerg Med. 2014;22:23. doi:10.1186/1757-7241-22-23U.S. Food and Drug Administration.FDA’s Approval of Veklury (Remdesivir) For the Treatment of COVID-19—the Science of Safety and Effectiveness.MedlinePlus.Remdesivir Injection.MedlinePlus.Albuterol.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Pediatrics.Updated guidance: use of palivizumab prophylaxis to prevent hospitalization from severe respiratory syncytial virus infection during the 2022-2023 rsv season.Ralston SL, Lieberthal AS, Meissner HC, et al.Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis.Pediatrics.2014;134(5):e1474-502. doi:10.1542/peds.2014-2742Hall CB, Weinberg GA, Blumkin AK, et al.Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age.Pediatrics.2013;132(2):e341-8. doi:10.1542/peds.2013-0303American Academy of Pediatrics.Bronchiolitis.Øymar K, Skjerven HO, Mikalsen IB.Acute bronchiolitis in infants, a review. Scand J Trauma Resusc Emerg Med. 2014;22:23. doi:10.1186/1757-7241-22-23U.S. Food and Drug Administration.FDA’s Approval of Veklury (Remdesivir) For the Treatment of COVID-19—the Science of Safety and Effectiveness.MedlinePlus.Remdesivir Injection.MedlinePlus.Albuterol.
American Academy of Pediatrics.Updated guidance: use of palivizumab prophylaxis to prevent hospitalization from severe respiratory syncytial virus infection during the 2022-2023 rsv season.
Ralston SL, Lieberthal AS, Meissner HC, et al.Clinical practice guideline: the diagnosis, management, and prevention of bronchiolitis.Pediatrics.2014;134(5):e1474-502. doi:10.1542/peds.2014-2742
Hall CB, Weinberg GA, Blumkin AK, et al.Respiratory syncytial virus-associated hospitalizations among children less than 24 months of age.Pediatrics.2013;132(2):e341-8. doi:10.1542/peds.2013-0303
American Academy of Pediatrics.Bronchiolitis.
Øymar K, Skjerven HO, Mikalsen IB.Acute bronchiolitis in infants, a review. Scand J Trauma Resusc Emerg Med. 2014;22:23. doi:10.1186/1757-7241-22-23
U.S. Food and Drug Administration.FDA’s Approval of Veklury (Remdesivir) For the Treatment of COVID-19—the Science of Safety and Effectiveness.
MedlinePlus.Remdesivir Injection.
MedlinePlus.Albuterol.
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