Comparison of two types of intravenous immunoglobulins in the treatment of neonatal sepsis.
In a prospective double-blind study, standard intravenous immunoglobulin (IVIG) was compared with an IgM-enriched IVIG in the treatment of neonatal sepsis. The two treatment groups were also compared with matched controls. One hundred and thirty babies (65 in each group) ranging from 0 to 24 days old, 480 to 4200 g in weight and born between 24 and 42 weeks of gestation who had, or were suspected of having, sepsis were given either standard IVIG or IgM-enriched IVIG (250 mg/kg per day) for 4 days in addition to supportive and antibiotic therapy. A further 65 babies who received similar supportive, antibiotic and fluids but not IVIG were used as matched controls. Mortality from infection in 'culture proven sepsis' was 3/44 (6.8%) in the IgM-enriched IVIG group, 6/42 (14.2%) in the standard IVIG group, and 11/43 (25.5%) in the control group (P = 0.017, IgM versus control, P = 0.19 standard IVIG versus control). There was no statistical difference in the outcome between the two immunoglobulin therapy groups (P = 0.25). The study indicates that IVIG improves outcome in neonatal sepsis when used as an adjunct to supportive and antibiotic therapy, but larger studies are required to confirm this.
Haque
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KN
Department of Paediatrics, College of Medicine, Riyadh, Saudi Arabia.
Remo
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Bahakim
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D002097:C-Reactive Protein / Q000378:metabolism; D004311:Double-Blind Method; D006801:Humans; D007075:Immunoglobulin M / Q000627:therapeutic use*; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007231:Infant, Newborn; D010976:Platelet Count / Q000187:drug effects; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000097:blood / Q000188:drug therapy; D013212:Staphylococcus epidermidis
D007075:Immunoglobulin M; D016756:Immunoglobulins, Intravenous; D002097:C-Reactive Protein