Intravenous immune globulin prophylaxis of late-onset sepsis in premature neonates
| Autor: | Charles T. Hankins, Leonard E. Weisman, Howard S. Heiman, K.N. Siva Subramanian, Thomas Rubio, David F. Cruess, C. Gilbert Frank, Thomas J. Kueser, Barbara J. Stoll, Gerald W. Fischer, Val G. Hemming |
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| Rok vydání: | 1994 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Birth weight Bacteremia Infant Premature Diseases Immunoglobulin E medicine.disease_cause Gastroenterology Sepsis Double-Blind Method Staphylococcus epidermidis Risk Factors Internal medicine Albumins medicine Humans Infusions Intravenous biology Dose-Response Relationship Drug business.industry Albumin Infant Newborn Immunoglobulins Intravenous biology.organism_classification medicine.disease Staphylococcus aureus Immunoglobulin G Pediatrics Perinatology and Child Health Immunology biology.protein Gestation Female Antibody business Follow-Up Studies |
| Zdroj: | The Journal of pediatrics. 125(6 Pt 1) |
| ISSN: | 0022-3476 |
| Popis: | To determine whether a single dose of intravenously administered immune globulin (IVIG) decreases late-onset sepsis in premature infants, we prospectively entered 753 neonates with birth weight 500 to 2000 gm, gestationor = 34 weeks, and ageor = 12 hours into a multicenter, double-blind, controlled trial. Infants were randomly selected to receive a single intravenous infusion, 10 ml/kg, of either IVIG (500 mg/kg) or albumin (5 mg/kg) and were observed for 8 weeks for infection. Maternal and neonatal risk factors for infection did not differ between groups. Although serum IgG values before infusion were related to gestation (R = 0.62), the change in serum IgG or half-life of IgG after IVIG infusion was not (Ror = 0.09). The serum IgG concentration was increased (p0.05) in IVIG-treated patients for 8 weeks. There were 88 episodes of late-onset sepsis in 79 neonates (10.5%). Causative organisms included the following: Staphylococcus epidermidis (37 episodes), Enterococcus (9), Staphylococcus aureus (7), Candida (6), Escherichia coli (6), and multiple organisms (11). Sepsis, death, and death as a result of infection were unaffected by treatment. We conclude that a single infusion of IVIG, 500 mg/kg, shortly after birth was not effective prophylaxis for late-onset infection in premature neonates. Future studies of late-onset sepsis prophylaxis should consider IVIG with known pathogen-specific antibody concentrations against organisms causing these infections, in particular S. epidermidis. |
| Databáze: | OpenAIRE |
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