There is no antiviral medication that cures RSV for most people. Treatment centers on managing symptoms at home with fluids, fever reducers, and nasal clearing techniques while the virus runs its course, typically over one to two weeks. What you take depends on who’s sick: an infant, an older child, or an adult.
Symptom Relief for Adults and Older Children
RSV in adults and children over age four generally feels like a bad cold: congestion, cough, sore throat, low fever, and fatigue. Standard over-the-counter options can take the edge off. Acetaminophen or ibuprofen helps with fever and body aches. Staying well-hydrated thins mucus and prevents dehydration, which makes everything feel worse. Warm liquids, honey (for anyone over age one), and throat lozenges can soothe a cough.
For nasal congestion in adults, saline nasal sprays help loosen mucus without side effects. Decongestant sprays or pills can offer short-term relief but shouldn’t be used for more than a few days. Most adults recover within a week or two without needing anything beyond these basics.
What to Give Infants and Young Children
RSV hits infants hardest, and the options are more limited. Babies under two should not be given any cough or cold product containing a decongestant or antihistamine. The FDA has flagged serious risks in this age group, including convulsions, rapid heart rate, and death. Manufacturers have voluntarily relabeled these products to warn against use in children under four.
For infants with RSV, the most effective tool is clearing their nose. Saline drops or spray loosens thick mucus, and gentle suctioning with a bulb syringe or a parent-operated nasal aspirator (like a NoseFrida) clears the airway so they can breathe and feed. The key word is “gentle.” Deep or forceful suctioning can irritate the nasal passages, cause swelling, and actually make congestion worse. Light suction of the nostrils after saline drops is enough.
Acetaminophen is appropriate for fever in infants over two months, and ibuprofen can be used after six months. Small, frequent feedings help prevent dehydration, since congested babies tire quickly during bottles or breastfeeding. A cool-mist humidifier in the room adds moisture to the air and can ease breathing, especially at night.
Why Antibiotics Don’t Help RSV
RSV is a virus, so antibiotics do nothing against it. Despite this, antibiotics get prescribed in a surprising number of RSV cases. One international study found antibiotics were used in about 23% of RSV hospitalizations and over 60% of RSV intensive care admissions, often because doctors suspected a secondary bacterial infection like an ear infection or pneumonia rather than treating the virus itself.
If your child has been sick with RSV for several days and then develops a new, higher fever or seems to get significantly worse after improving, a bacterial infection on top of the virus is possible. That’s the scenario where antibiotics become relevant. But for the RSV infection itself, they won’t shorten the illness or reduce symptoms.
Prescription Treatments for Severe Cases
For the small percentage of patients hospitalized with severe RSV, treatment focuses on oxygen support and IV fluids. There is one antiviral, ribavirin, approved in inhaled form for severe RSV lung infections in children. In practice, it’s rarely used because it’s expensive, difficult to administer, and carries safety concerns for healthcare workers and pregnant women nearby. Some hospitals have shifted toward an oral form, though there isn’t strong evidence yet showing it helps.
Most hospitalized patients, including both children and older adults, receive supportive care: supplemental oxygen if blood oxygen levels drop, fluids to maintain hydration, and monitoring until the worst of the illness passes. Hospital stays for RSV bronchiolitis in infants typically last two to five days.
Prevention for Infants
Because treatment options are so limited, prevention matters enormously for babies. A protective antibody called nirsevimab (sold as Beyfortus) is now recommended for infants during RSV season, which runs roughly October through March in most of the United States. It’s not a vaccine but a single injection that gives babies ready-made antibodies to fight RSV.
The dosing is weight-based. Babies under 11 pounds receive 50 mg, those 11 pounds and over get 100 mg, and children between 8 and 19 months who qualify for a second season of protection receive 200 mg as two injections. Infants born during RSV season should ideally get the shot within a week of birth, during the birth hospitalization. Babies born between April and September should receive it shortly before RSV season begins, around October or November.
RSV Vaccines for Older Adults
Adults 75 and older are now recommended to get a single dose of an RSV vaccine. Adults between 50 and 74 also qualify if they have conditions that raise their risk of severe illness. The list of qualifying conditions is broad: heart disease, chronic lung conditions like COPD or asthma, kidney disease requiring dialysis, complicated diabetes, liver cirrhosis, sickle cell disease, severe obesity (BMI of 40 or higher), moderate to severe immune compromise, or living in a nursing home. Three vaccines are currently licensed for adults 50 and older.
Unlike the infant antibody, these are true vaccines that train your immune system to recognize RSV. A single dose provides protection, and the CDC has not yet recommended a booster schedule.
Signs That Home Care Isn’t Enough
Most RSV infections resolve at home. But certain warning signs, especially in babies, mean the illness has become more serious. Watch for visible effort with each breath: the skin pulling in between the ribs or below the ribcage, nostrils flaring with each inhale, or fast, shallow breathing. A baby who refuses to drink or has significantly fewer wet diapers is getting dehydrated. Bluish color around the lips or fingernails signals low oxygen. Any of these signs in an infant warrants immediate medical attention. In older adults, increasing shortness of breath or confusion are the equivalent red flags.