Pediatric Enteroviral Infections Medication

Updated: Jun 16, 2017
  • Author: Nicholas John Bennett, MBBCh, PhD, MA(Cantab), FAAP; Chief Editor: Russell W Steele, MD  more...
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Medication

Medication Summary

Antiviral therapy is not currently a component in the standard of care for enteroviral infection. Studies with investigational antiviral agents are currently ongoing. Current treatment remains purely supportive.

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Antipyretic and analgesic agents

Class Summary

These agents are used to treat fever, myalgia, and headache associated with enterovirus.

Acetaminophen (Tylenol, FeverAll)

Analgesic effect and also reduces fever by directly acting on hypothalamic heat-regulating centers, which increases dissipation of body heat via vasodilation and sweating. 

Ibuprofen (Motrin, Advil)

For use as an analgesic.

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Immunoglobulins

Class Summary

This agent is a purified preparation of gamma globulin derived from large pools of human plasma and is composed of 4 subclasses of antibodies, approximating the distribution of human serum.

Immune globulin, intravenous (Carimune NF, Gammagard, Polygam S/D)

Neutralizes circulating myelin antibodies through anti-idiotypic antibodies. Down-regulates proinflammatory cytokines, including INF-gamma. Blocks Fc receptors on macrophages. Suppresses inducer T and B cells and augments suppressor T cells. Blocks complement cascade and promotes remyelination. May increase CSF IgG (10%).

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Antiviral agents

Class Summary

One antiviral medication (pleconaril) has shown promise in treating enteroviral infections, but its use has so far been largely restricted to experimental protocols. Its release has been repeatedly delayed, and it is still not yet licensed in the United States.

Pleconaril (Picovir)

Low-molecular weight capsid-inhibitor fits into the hydrophobic pocket of the VP1 capsid protein and interferes with viral attachment and uncoating. Has shown some efficacy in a neonatal sepsis in one small RCT.

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