Oral immunoglobulin for the treatment of rotavirus infection in low birth weight infants.
BACKGROUND
Rotavirus infection is the most common neonatal nosocomial viral infection. Epidemics with the newer P(6)G9 strains have been reported in neonatal units worldwide. These strains can cause severe symptoms in most infected infants. Infection control measures become necessary and the utilisation of hospital resources increase. Local mucosal immunity in the intestine to rotavirus is important in the resolution of infection and protection against subsequent infections. Boosting local immunity by oral administration of anti-rotaviral immunoglobulin preparations might be a useful strategy in treating rotaviral infections, especially in low birth weight babies.


OBJECTIVE
To determine the effectiveness and safety of oral immunoglobulin preparations for the treatment of rotavirus infection in hospitalised low birthweight infants (birth weight less than 2500 gms)


METHODS
Electronic databases including The Cochrane Controlled Trials Register (The Cochrane Llibrary, Issue 2, 2002), MEDLINE (1966 - June 2002), EMBASE (1980 - June 2002) and CINAHL (1982 - June 2002) were searched by the strategy outlined in the protocol. Science Citation Index search for all articles which referenced Barnes 1982 were searched. The proceedings of the Pediatric Academic Societies which were published in the journal, Pediatric Research, from 1991 were searched as well as abstracts of the doctoral dissertations and theses from 1960. All of the above search strategies were completed in June 2002. Authors prominent in the field were contacted for any unpublished articles and more information on published articles was sought. Reference lists of identified clinical trials and personal files were also reviewed.


METHODS
The criteria used to select studies for inclusion were: 1) DESIGN: randomised or quasi-randomised controlled trials 2) Hospitalised low birthweight infants with rotavirus infection 3) INTERVENTION: Oral immunoglobulin preparations compared to placebo OR no intervention 4) At least one of the following outcomes were reported: All cause mortality during hospital stay, mortality due to rotavirus infection during hospital stay, duration of diarrhoea, need for rehydration, duration of viral excretion, duration of infection control measures, length of hospital stay in days, recurrent diarrhoea or chronic diarrhoea


METHODS
The two reviewers were to independently abstract data from eligible trials. No data analysis was possible at this point.


RESULTS
No eligible randomised controlled trials were found.


CONCLUSIONS
We found no randomised controlled trials which assessed the effectiveness or safety of oral immunoglobulin preparations for the treatment of rotavirus infections in hospitalised low birthweight infants.
Mohan
P
P
International Neonatal Immunotherapy Study, National Perinatal Epidemiology Unit, Oxford, UK. pammi.mohan@perinatal-epidemiology.oxford.ac.uk
Haque
K
K
D000284:Administration, Oral; D003428:Cross Infection / Q000628:therapy* / Q000821:virology; D003967:Diarrhea / Q000628:therapy* / Q000821:virology; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D012400:Rotavirus Infections / Q000628:therapy*
D007136:Immunoglobulins