Introduction Viral lower respiratory tract infections are common in lung transplant patients and contribute to the development of chronic rejection. Studies have highlighted the improvement in lung function and reduction in relative risk of chronic rejection in patients who are treated with appropriate anti-virals. Our study aimed to investigate the efficacy of three different routes of administration in patients with symptomatic declines in lung function and positive viral cultures.

Method Retrospective cohort study of viral respiratory tract infections treated with Ribavirin over a 5 year period was performed. Patients were divided in to 3 groups dependent on route of administration – Oral, Nebulised or Intravenous. Data was collected on patient demographics along with the indication for transplant, time since transplantation, pre and post treatment (6–8 weeks) lung function, viral cultures and details of any confounding factors such as prior rejection or concomitant bacterial infection were recorded.

Results 47 patients were identified. 12 patients were excluded due to insufficient clinical data. Of the remaining 34 patients, 11 were treated with Oral medication, 13 with Nebulised and 10 with Intravenous.

Conclusion Treatment with Ribavirin results in an improvement in lung function. In this small study it appears that there is no difference in lung function between the different routes of administration. Whilst the efficacy appears comparable oral treatment offers significant advantage to the patients and has benefits for treatment cost and bed occupancy.