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ISSN: 2394-4137 (E) 2394-6318 (P)

IJIMS.2015.115

Type of Article: Original Research

Volume 2; Issue 5 : May 2015

Page No.: 115-120

DOI: 10.16965/ijims.2015.115

 

Randomized Control Trial of IVIG as An Adjuvant in the Treatment of Preterm and or Low Birth Weight Neonatal Sepsis

Sekar M.N 1, Anjan Kumar VS *2, Ravi Kumar P 3, Siva Ramudu K 4, Mallikarjuna M 5, Sasi Kumar B 1.

*1,2,4,5,6 Assistant Professor, Department of Pediatrics, Sri Venkateswara Medical College, Tirupati, Andhra Pradesh, India.

3 Professor and Head, Department of Pediatrics, Sri Venkateswara Medical College, Tirupati, Andhra Pradesh, India.

 

CORRESPONDENCE: Dr.V.S.Anjan Kumar MD, Assistant Professor, Department of Pediatrics, Sri Venkateswara Medical College, Tirupati, Andhra Pradesh, India. E-Mail: dr.anjankumar@gmail.com

 

ABSTRACT

Introduction: In developing countries neonatal sepsis ranks as most common illness responsible for neonatal mortality especially in low birth weight and preterm babies. In India, it is responsible for 25-50% of neonatal deaths in spite of early diagnosis and treatment. There have been many trials on various adjuvant therapies (like leukocyte transfer, GCSF, GMCSF, fibronectin, IVIG, FFP) in addition to specific antimicrobial therapy. There is still some controversy in the role of IVIG in treatment of neonatal sepsis. Hence the study was undertaken to evaluate the efficacy of IVIG in treatment of neonatal sepsis.

Materials and methods: 30 in group total 60 babies with gestation £ 32 wks and wt £2000 gm were enrolled in the study if they had one or more clinical features of sepsis and had elevated C –reactive protein (>10mg/dl). Babies in both groups underwent investigations including micro ESR, WBC count, ANC, Platelet count, LFT, Blood culture & Urine culture. In IVIG group samples were drawn before giving IVIG.

Results: There is no significant decrease in mortality, severity of illness and duration of hospital stay in IVIG group than control group.

Conclusions: As of other studies, our study also did not show any significant role of IVIG as an adjuvant in the treatment of sepsis in preterm or low birth weight neonates.

KEY WORDS: Leukocyte transfer, GCSF, GMCSF, Fibronectin, IVIG and FFP.

 

REFERENCES

  1. Neonatal sepsis: Based on the proceedings of a single theme workshop on neonatal sepsis – February 2002 PGIMER. Chandigarh.
  2. Kurien Anil Kuruvilla, Swathi Pillai. Bacterial profile of sepsis in a neonatal unit in South India. Indian Paediatrics Volume 35:Sep.1998:851-858.
  3. Mehrban Singh, Care of the newborn, 5th Current status of perinatal care in India. Pg. 16-17.
  4. Kavitha Bhola et al. Clinico-pathologcial profile of culture positive neonatal septicemia. Published in the XXIII convention of the National Neonatology Forum. Page. 1.
  5. J. Stoll. Nellie Hansen. Late onset of sepsis in very low birth weight neonates. The experience of NICHD neonatal Research Network. Paediatrics 2002;110(2):285-290.
  6. H.O 1995 – Bridging the gaps. 1995 WHO report of the Director General.
  7. Report of the National Seminar on traditional practices in mother and child care National Institute of public co-operation and child development, New Delhi 1989.
  8. Mahapatra S.S., Baag, R.K : Customs and beliefs on neonatal care in a tribal community. Ind. Paediatrics. 1982;19:675–8.
  9. R. Makhoul, Polo Sujov. Epidemiological, clinical and microbiological characteristics of late onset sepsis among very low birth weight infants in Israel. A National survey. Paediatrics 2002;109(II):34-6.
  10. Nelson textbook of Paediatrics, 17th Saunders, Richard Bergman. Robert. M.Kliegman, Hall. B. Janson.
  11. Weisman LE, Stoll BJ, Kenser TJ et al. IVIG therapy for early onset sepsis in premature neonates. J. Pediat. 1992;121:434-43.
  12. Christenson KK, Christenson P, Bucher HV, et al. IV administration of human IgG to newborn Infants. Changes in serum antibody levels to group B streptococci Eur. J. Pediatr.1984;143:123-127.
  13. Friedman CA. Wender DF, Temple DM, et al. IVIG as adjuvant therapy for severe Group B streptococcal disease in NB. Am. J. Perinatol 1990;7:1-4.
  14. Haque KN, Zadir MH, Haque SK et al. IVIG for prevention of PT sepsis, Pediatr. Inf. Dis. 1986;5:622-5.
  15. De Muralt G, Sidiroplous D. Replacement therapy with Ig in neonatology, Presse Med. 1983;12:2595-602.
  16. Jenson AB, Pollock BH. The role of IVIG for prevention and treatment of NN sepsis. Semin Perinatol. 1998;22:50-63.
  17. Kinney J, Mundorf L, Gleason C et al. Efficacy and Pharmacokinetics of IVIG admn to high risk neonates. AJOC 1991;145:1233–38.
  18. Fanaroff AA. Korones SB, Wright LL et al. A controlled trial of IVIG to reduced nosocomial infection in VLBW infant. N. Eng. J. Med. 1994;330:1107-13.
  19. Magay JF, Oury CB, Brautt D, et al. IVIG therapy for prevention of infection in high risk premature infants – Reports of a multicenter double blind study. Paediatrics 1991;88: 437–42.
  20. Chirico G, Rondini G. Plebani A et al. IVIG therapy for prophylaxis of infection in high risk neonates. J. Pediatri. 1987;110:437 – 42.
  21. Canway SP, Gilles DRN, Dochety A. NN infection in premature infants and use of human Ig. Arch. Dis. Child. 1987;62:1255-56.
  22. Stabile A, Sopo SM. Romanelli V, et al IVIG for prophylaxis of NN sepsis in premature infants. Arch. Dis. Child 1988;63:441-43.
  23. Mankarious S Lee M, Fisher S, Pyun KK, Ochs HD et al. The half lives of IgG subclasses and specific antibodies in patients of primary immunodeficiency who are receiving IVIG. J.Lab. Clin. Med. 1988;112:634-640.
  24. Michael D. Weiss, David J. Burchfield. Adjunct Therapies to Bacterial Sepsis in the Neonate NAINR. 2004;4(1).

 

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