The increased use of IgIV has heightened our recognition of the range of associated adverse events, several of which have been reported since the original committee recommendations. The incidence of aseptic meningitis following IgIV infusion may be higher than previously thought, part icularly with infusion at very high doses (2 g/kg). Non-A, non-B hepatitis had not previously been reported in products licensed in North America; however, cases of hepatitis C have now been associated with IgIV from one manufacturer in the United States during a brief period in 1993. Additional methods of viral inactivation used by other manufacturers should reduce this risk; however, because of the risk of transmission of as yet unknown blood-borne infections, IgIV should be used only if there is a clear indication. Furthermore, our understanding is increasing of the pofential effect of high doses of IgIV on the response to live virus vaccines, particularly measles. In the original committee recommendations, a delay of measles immunization for three months after IgIV infusion was suggested. More recent recommendations suggest a delay of from three to 11 months depending on the product and dose of immune globulin given.
Based on these additional data, the Infectious Diseases and Immunization Committee believes that there is sufficient information to modify the previously published guidelines. The committee now considers IgIV therapy of probable (rather than possible) efficacy for treatment of Guillain-Barre syndrome, refractory dermatomyositis and for prophylaxis for cmv infections after bone marrow transplantation. In contrast, recent data are less supportive of routine use of IgIV for prophylaxis against nosocomial infections in low birth weight neonates; therefore, the committee now considers this use of possible efficacy (rather than probable efficacy). Because of conflicting data, the committee continues to consider as probable efficacy the use of IgIV in children with him infection and in children who receive a bone marrow or organ transplant. You can finally spend less money and time whenever your need * since you are being given access to the best online pharmacy you have ever come across.You can finally spend less money and time whenever your need since you are being given access to the best online pharmacy you have ever come across.