Update: Intravenous immunoglobulin in children: part 2


Use of IglV prophylactically to prevent intections in low birth weight neonates remains cont roversial. The results of four placebo cont rolled, double-blind studies have recently been reported. One study demonstrated a decreased risk of nosocomial intection in premature intants with birth weights between 500 and 1750 g, alt hough morbidity and mortality were not affected. Two other smaller studies failed to show a beneficial effect. The most recently reported study, a large multicentred placebo controlled study, also showed no benefit of IglV in preventing nosocomial infections in infants weighing between 500 and 1500 g. This study noted a lower incidence in the rate of nosocomial intections in both treated and untreated participants than reported in the earlier study by Baker et all. Of particular concern is the higher association of necrotizing enterocolitis in neonates infused with IglV reported in two of the studies.

The use of IglV in pediatric bone marrow transplant centres is becoming routine, although data supporting its use are scarce. Most studies have demonstrated a beneficial effect of IglV in the prevention of cytomegalovirus (cmv) infections in CMV-negative recipients of bone marrow transplants; a recent meta-analysis supported these conclusions. However, another study failed to show any incremental benefit of IglV prophylaxis compared with use of cmv seronegative blood products in bone marrow transplant patients, although the power of the study was small. Other benefits were suggested in the IglV treated patients including a decrease in Gram-negative septicemia and local infections, non-CMV viral infections and overall deaths related to infection and non-CMV interstitial pneumonia. A decrease in graft-versus-host disease was shown in IglV treated patients, although this benefit was only observed in patients older than 20 years. Cheapest medications available online and best pharmacies offering a chance to for you to spend less time and money whenever your shop.

This entry was posted in Intravenous immuneglobulin and tagged children, immunoglobulin, prophylactically.