PT - JOURNAL ARTICLE AU - Brian K Walsh AU - Yingguang Liu TI - Effect of Vibrating Mesh Nebulizer Aerosol Technology on the In Vitro Activity of Ribavirin Against Respiratory Syncytial Virus AID - 10.4187/respcare.09244 DP - 2021 Sep 27 TA - Respiratory Care PG - respcare.09244 4099 - http://rc.rcjournal.com/content/early/2021/09/27/respcare.09244.short 4100 - http://rc.rcjournal.com/content/early/2021/09/27/respcare.09244.full AB - Background: Ribavirin is an antiviral drug that for many years has been administered to the lungs by aerosolization. Despite advancements in oral delivery routes, there has been a renewed interested in delivering ribavirin via the pulmonary system in select and the severely ill. The vibrating mesh nebulizer (VMN) was previously demonstrated to be an effective alternative to the small particle aerosol generator (SPAG) in particle size, chemical makeup, and concentrations of the ribavirin pre and post nebulization. However, the antiviral activity of ribavirin has never been examined. We sought to study ribavirin’s activity pre and post nebulization via VMN. Methods: We grew and infected human epithelial type 2 cells (HEp2) and primary airway epithelial cells with respiratory syncytial virus (RSV). We then compared the antiviral effect of non-nebulized (control) and aerosolized ribavirin to untreated controls. We used traditional plaque assay and real-time polymerase chain reaction to determine the quantity of virus. Results: Both non-nebulized (control) and nebulized ribavirin reduced the size of RSV plaques compared to untreated controls. Additionally, the non-nebulized and nebulized ribavirin equally inhibited RSV replication. There were no statistically significant differences between the non-nebulized and nebulized ribavirin across all time points. Conclusions: The VMN nebulizer does not affect the antiviral properties of nebulized ribavirin when compared to non-nebulized drug. Our findings add supporting evidence for the use of the VMN in the administration of inhaled ribavirin.