Prolonged intravenous immunoglobulin treatment in very low birth weight infants with late onset sepsis.
J Neonatal Perinatal Med
; 13(3): 381-386, 2020.
Article
em En
| MEDLINE
| ID: mdl-31771081
ABSTRACT
BACKGROUND:
Neonatal infections are a leading cause of morbi-mortality despite advances in antimicrobials and neonatal care. Preterm infants have greater susceptibility to sepsis due to an immature immune system and lower immunoglobulin levels. Intravenous immunoglobulins (IVIG) have been used in several studies as an adjuvant treatment to improve this physiological immune deficiency, with different outcomes.METHODS:
Very low birth weight (VLBW) infants who developed sepsis in the neonatal ICU were studied. They were randomly divided in 2 groups one group was treated with antibiotics (Group I), and the other received antibiotics plus a 500âmg/kg/day of IVIG during 7 days (Group II). Serum IgG concentration was determined at initiation, during and after treatment Group I, and daily during the 7 days of therapy in Group II.RESULTS:
The baseline IgG concentration in group II was 486âg/dL, and increased to 852âmg/dL after the first dose of IVIG (pâ<â0.01). After the seventh day of infusion a mean IgG level of 1898âmg/dL was achieved. A direct correlation (râ=â0.94) between IgG concentration and days of treatment was observed. Blood cultures were positive in 70% of the infants in group I and 75.5% in group II. Staphylococcus epidermidis was the most frequent isolated bacteria in blood cultures. The lethality rate was 25.0% in group I and 5.0% in Group II (pâ<â0.03). We did not observe collateral effects with the administration of IVIG.CONCLUSIONS:
Prolonged therapy with IVIG seems to be safe and effective as an adjuvant treatment in VLBW infants with sepsis.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Recém-Nascido Prematuro
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Imunoglobulinas Intravenosas
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Sepse Neonatal
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Duração da Terapia
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Doenças do Prematuro
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article