title: Myeloid colony-stimulating factors: use in the newborn.
abstract: Bacterial and fungal sepsis are major causes of morbidity and mortality in the newborn. Multiple factors contribute to this increased susceptibility to infection, including quantitative and qualitative neutrophil defects, with a reduction in neutrophil number and function. Neutropenia in the newborn may occur in association with sepsis and has a poor prognosis. In addition to antibiotic therapy and supportive care, granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) have been used to reduce morbidity and mortality. Granulocyte CSF is the physiological regulator of neutrophil production and function. Administration of G-CSF results in increased neutrophil production and counts and improved neutrophil function. Several studies of animal and human newborns having neutropenia or suspected sepsis investigated the use of G-CSF and GM-CSF to elevate neutrophil counts and reduce morbidity and mortality in this population. Results of small clinical trials using G-CSF and GM-CSF in very low-birth-weight infants having neutropenia show increased neutrophil counts and a reduced incidence of sepsis during the neonatal period. Despite these promising early results, further studies of the safety and efficacy of G-CSF and GM-CSF administration in neonates are required before their routine use can be recommended as either prophylaxis or treatment for neonatal sepsis.
authors.affiliation: Neonatal Intensive Care Unit, Royal Alexandra Hospital, Edmonton, Alberta, Canada.
authors.forename: C
authors.initials: C
authors.lastname: Sreenan
authors.forename: H
authors.initials: H
authors.lastname: Osiovich
mesh_terms: D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology / Q000502:physiology / Q000627:therapeutic use*; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000494:pharmacology / Q000502:physiology / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000188:drug therapy*; D019102:Infant, Very Low Birth Weight; D009503:Neutropenia / Q000188:drug therapy*; D009504:Neutrophils / Q000502:physiology; D018805:Sepsis / Q000188:drug therapy*
chemical_list: D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor