Evaluation of a new premedication protocol for administration of equine rabies immunoglobulin in patients with hypersensitivity.
OBJECTIVE
The present study was undertaken to standardize skin testing and to develop a safe and effective premedication protocol for administration of ERIG in those with skin test positivity/hypersensitivity.


METHODS
A method of grading of skin testing was developed using injection histamine as a positive control. This was evaluated by using it on 517 subjects who had severe (WHO category III) exposure to rabies. A premedication protocol consisting of injections pheniramine, ranitidine, hydrocortisone and adrenaline was evaluated by using it on fifty one subjects who were skin test positive/hypersensitive to ERIG.


RESULTS
The premedication protocol was safe and effective as all the S1 subjects could be administered the full dose of ERIG despite being skin test positive/hypersensitive to ERIG. Besides the premedication drugs/protocol did not affect the immune response to vaccine and ERIG therapy.
Sudarshan
M K
MK
Principal and Professor of Community Medicine, Community Medicine, Kempegowda Institute of Medical Sciences, Bangalore. mksudarshan@vsnl.com
Kodandaram
N S
NS
Venkatesh
G M
GM
Mahendra
B J
BJ
Ashwath Narayana
D H
DH
Parasuramalu
B G
BG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D004342:Drug Hypersensitivity / Q000150:complications / Q000517:prevention & control*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006736:Horses; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D007223:Infant; D007231:Infant, Newborn; D007428:Intradermal Tests; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011818:Rabies / Q000150:complications / Q000517:prevention & control*; D011819:Rabies Vaccines / Q000008:administration & dosage*; D011899:Ranitidine / Q000627:therapeutic use
D005938:Glucocorticoids; D006634:Histamine H1 Antagonists; D007136:Immunoglobulins; D011819:Rabies Vaccines; D011899:Ranitidine