Table 1.

Treatment algorithm of respiratory viral infections after HCT.

(1) Steroid dose withdrawal (if applicable) below 1 mg/kg/day (except for IFV)
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(2) In case of LRI or high risk factors: start specific treatment
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Virus	RSV	PIV	HMPV	RhV	AdV	IFV
First-line treatment recommendations	Oral ribavirin 30 mg/kg/day in 3 divided doses, 10 days				IV Cidofovir 5 mg/kg once a week (2w) and 5 mg/kg once every fortnight	Oral oseltamivir 75 mg bid (30 mg bid 10–15 kg, 45 mg bid 16–23 kg,. 60mg bid 24-40 kg) for 10 days
Alternative treatment	+IVIG IV ribavirin Inhaled ribavirin Palivizumab (young children)				Oral brincidofovir (2mg/kg twice a week] Anti-ADV CTL	NAI: inhaled zanamivir IV peramivir Zanamivir (if resistance) M2 ion channel inhibitor: amantadine (IV-A)
Drugs/immunotherapy in development	GS-5806 MDT-637 ALX-0171 Favipiravir RSV-604 AL-8176 ALN-RSV01 RI-001	DAS 181 Anti PIV-3 CTL	MAb 338	Oral/nasal pleconaril vapendavir	HBX	Inhaled laninamivir Nitazoxanide MEDI8852 VIS410
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(3) Virus spread prophylaxis: hand hygiene, surgical mask, vaccination of family, prolonged isolation

AdV, adenovirus; HMPV, human metapneumovirus; RhV, rhinovirus; IFV, influenza virus ; IVIG, intravenous polyvalent immunoglobulins ; LRI, lower respiratory tract infection; NAI, neuraminidase inhibitor; PIV, parainfluenza virus; RSV, respiratory syncytial virus.