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The Effectiveness of Intravenous Immunoglobulin for Clinically Suspected Neonatal Sepsis

Korean Journal of Pediatrics 2005;48(11):1187-1192.
Published online November 15, 2005.
The Effectiveness of Intravenous Immunoglobulin for Clinically Suspected Neonatal Sepsis
Hyun Jung Na, Ji Young Kim, Gyeong Hoon Lee, Jun Hwa Lee, Eun Jin Choi, Jin Kyung Kim, Hai Lee Chung, Woo Taek Kim
Department of pediatrics, School of Medicine, Catholic University of Daegu, Daegu, Korea
임상적으로 의심되는 신생아 패혈증에서 정맥용 면역 글로불린의 치료 효과
나현정, 김지영, 이경훈, 이준화, 최은진, 김진경, 정혜리, 김우택
대구가톨릭대학교 의과대학 소아과학교실
Correspondence: 
Woo Taek Kim, Email: wootykim@cu.ac.kr
Abstract
Purpose
: The purpose of this study is to determine the effectiveness of intravenous immunoglobuin (IVIG) administration in fullterm neonates having clinically suspected neonatal sepsis.
Methods
: Forty full-term neonates admitted to the neonatal intensive care unit with clinically suspected neonatal sepsis, who had at least two positive diagnostic criteria were enrolled. Twenty neonates were enrolled into the IVIG arm and 20 in the placebo arm. Neonates with a gestational age of less than 36 weeks and those with any major congenital malformation were excluded. The neonates were randomized to receive 1 g/kg of IVIG or equivalent amount of normal saline. The treatments including antibiotics and supportive care were administered.
Results
: The neonates in the therapy and placebo groups were comparable in terms of birth weight, gestational age, sex distribution, duration of antibiotics therapy and admission, elevation of serum IgG level, mortality rate, change of CBC, and serum level of acute phase reactants etc.
Conclusion
: Serum IgG values increased significantly 5 days after administration of IVIG in the IVIG-treated group and decreased significantly 5 days after administration of normal saline in the placebo group. However, there was no significant difference in the duration of antibiotics therapy and admission, or of mortality between the IVIG-treated and placebo groups. No adverse reactions to the IVIG infusions were noted during the study. Our preliminary observations suggest that the administration of 1 g/kg IVIG to neonates had some effect on augmentation of humural immune status in neonates with clinically suspected sepsis. But further study is needed to verify the benefit of IVIG infusion to neonatal sepsis.
Key Words: Neonatal sepsis , Intravenous immunoglobulin


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