From the Guidelines
For elderly patients with Respiratory Syncytial Virus (RSV), treatment is primarily supportive and can include several over-the-counter options. The primary goal of treatment is to manage symptoms and support the body's immune system as it fights the viral infection. Some key supportive measures include:
- Acetaminophen (Tylenol) at 325-650 mg every 4-6 hours (not exceeding 3,000 mg daily) to reduce fever and relieve pain 1
- Ibuprofen (Advil, Motrin) at 200-400 mg every 6-8 hours with food to help with inflammation and discomfort, though it should be used cautiously in those with kidney issues or on blood thinners 1
- Staying well-hydrated by drinking plenty of fluids to thin mucus secretions
- Saline nasal sprays to moisturize nasal passages and loosen congestion
- Honey in warm tea (1-2 teaspoons) to soothe cough symptoms
- Using a humidifier to add moisture to the air, easing breathing difficulties
- Rest is essential for recovery
Elderly patients should seek medical attention if they experience difficulty breathing, persistent high fever, or worsening symptoms, as they may require more intensive care due to their higher risk for RSV complications 1. It's also important to note that RSV vaccination is recommended for people aged ≥50 years with risk factors and all persons aged ≥60 years, as it can help prevent RSV-associated disease and its complications 1.
In terms of specific treatment options, there are limited data on the effectiveness of antiviral therapies for RSV, and treatment is often focused on managing symptoms and supporting the body's immune system 1. However, some studies have suggested that ribavirin and IVIG may be effective in treating RSV infection in immunocompromised patients, although more research is needed to confirm these findings 1.
Overall, the key to managing RSV in elderly patients is to provide supportive care, manage symptoms, and prevent complications. By taking a comprehensive approach to care, healthcare providers can help reduce the risk of severe illness and improve outcomes for elderly patients with RSV.
From the FDA Drug Label
The vast majority of infants and children with RSV infection have disease that is mild, self-limited, and does not require hospitalization or antiviral treatment. The FDA drug label does not answer the question.
From the Research
Supportive Over-the-Counter (OTC) Treatment Options for RSV in the Elderly
The standard of care for RSV-infected patients remains supportive, including:
- Fluids
- Antipyretics
- Oxygen support when needed 2 Other supportive care measures may include:
- Rest
- Hydration
- Over-the-counter medications for symptom relief, such as cough suppressants and expectorants
Limitations of Current Treatment Options
There are few evidence-based RSV-specific treatments currently available, with supportive care being the main modality 3 Treatment is mainly symptomatic, with no specific antiviral agents available for RSV infections in elderly adults 4
Development of New Treatments and Preventive Strategies
New antiviral treatments for RSV are in the early stages of development, but it will be years until any of these may be licensed by the US Food and Drug Administration (FDA) 5 Preventing RSV disease would be possible through RSV vaccine development, and new long-acting monoclonal antibodies have demonstrated promising results in early clinical trials 5 Two protein subunit vaccines for protection from severe RSV in adults aged 60 years and older were licensed in 2023, and a third-an mRNA-based vaccine-recently gained market approval in the USA 3