[Intravenous immunoglobulin in the treatment of neonatal septicemia].
Thirty-seven neonates with confirmed septicemia through hemoculture were studied. Of them, 18 were treated with antibiotic and the other 19 were given 500 mg/kg of intravenous immunoglobin with a pH of 4.25 (IGIV). The greater part of the neonates in this study were full-term or near full-term. There were no differences in age, gestational age and weight, nor in mortality, the bacterias found and the clinical manifestations which were seen in both groups. Yet, the hospitalary stay was shorter for those in the group treated with IGIV (13.9 +/- 5.7 days) than in the trial group (24.4 +/- 10.3 days); as well as some clinical manifestations like diarrhea and splenomegalia (P < 0.05). The serum of the neonates from the IGIV group showed a greater capacity of opsonization and inhibition of bacterial growth than those in the trial group (P < 0.001), coinciding with an increase of 300 mg/dL in the serum levels of IgG of the group treated with IGIV from the 3rd day of the study and the C4 and B-Properdine factor serum levels from the 7th day of the study, while in the trial group, there were no changes in these factors (P < 0.001). Even though no differences were seen in the mortality rate due to septicemia, the results suggest a much shorter evolution of the illness in patients treated with IGIV. In addition, the serum of those patients treated with IGIV showed in in vitro studies, a better bacteriostatic activity and a better capacity to opsonize the bacterias isolated in the hemocultures.(ABSTRACT TRUNCATED AT 250 WORDS)
Mancilla-Ramírez
J
J
Departamento de Neonatología, Hospital Infantil de México Federico Gómez, D.F.
González-Yunes
R
R
Castellanos-Cruz
C
C
García-Roca
P
P
Santos-Preciado
J I
JI
D016470:Bacteremia / Q000097:blood / Q000628:therapy*; D003181:Complement C4 / Q000032:analysis; D011415:Complement Factor B / Q000032:analysis; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007231:Infant, Newborn; D008297:Male; D010587:Phagocytosis; D015610:Serum Bactericidal Test
D003181:Complement C4; D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D011415:Complement Factor B
Inmunoglobulina intravenosa en el tratamiento de septicemia neonatal.