Bont L, MD, Baraldi E, Fauroux B, Greenough A, Heikkinen T, Manzoni P, Martinón-Torres F, Nair H, Papadopoulos NG, on behalf of ReSViNET.
THE NEED FOR RSC RESEARCH NETWORKS
Key research questions can seldom be answered without multidisciplinary and networking approaches. For influenza such approaches have been developed (GABRIEL, isirv, MISMS and CEIRS). The BRaVe initia- tive by World Health Association is an action plan to decrease the unmet global burden of respiratory viruses in general. TB-net is a net- work to promote clinically oriented research in the field of tuberculosis in Europe by shar- ing and developing ideas and research pro- tocols. Despite the major burden of disease, there is no international, integrated, multidis- ciplinary and translational research approach focused on RSV infections. National RSV networks, such as the Italian Neonatology Study Group on RSV Infections and the Dutch RSV Neonatal Network do not have the multidisciplinary potential to address most major scientific challenges. At the same time, research interest in RSV keeps growing, with an increasing number of studies underway and more to appear with the development of new preventive and therapeutic molecules. Most trials are currently being performed in the United States and Europe, with twice as much studies in the United States as in Europe (Fig. 1). In this setting, ReSViNET is a new fully independent research network with the mission to decrease the global bur- den of RSV infection by integrating exper- tise. It addresses the burden of RSV by estab- lishing a European translational research framework and by delivering a comprehen- sive training and education program. ReSVi- NET is stimulating and performing research aiming to understand and tackle the burden of RSV infection, to advocate for better care for patients with RSV infection, to provide education related to RSV infection and to provide effective partnerships with relevant stakeholders. Although founded by European researchers, the network open to researchers outside of Europe, such as investigators from developing countries through RSV GEN led by University of Edinburgh. Combining expertise will eventually enable streamlining research efforts to decrease the global burden of RSV infection.
Farley R, Spurling GKP, Eriksson L, Del Mar CB.
Antibiotics are not effective in acute viral bronchiolitis. Nevertheless, they are used in 34-99% of bronchiolitis cases. Bronchiolitis is a viral respiratory tract infection, often caused by RSV. Farley and colleagues reviewed 7 trials with a total of 824 patients evaluating the effectiveness of antibiotics in bronchiolitis. Except for one large trial, these studies were placebo-controlled.
This systematic review did not find evidence for a beneficial effect of antibiotics. Length of stay was similar in 350 infants treated with azithromycin versus placebo (5.2 vs 5.8 days). The authors conclude that antibiotics should not be used in bronchiolitis, although they keep the possibility open that antibiotics are needed for a subgroup of mechanically ventilated infants. This publication shows that withholding antibiotics to infants with bronchiolitis may have an important beneficial effect on the global rise of antibiotic resistance without affecting disease outcome.