TY - JOUR
T1 - Treatment of neonatal sepsis with intravenous immune globulin
AU - Brocklehurst, Peter
AU - Farrell, Barbara
AU - King, Andrew
AU - Juszczak, Edmund
AU - Darlow, Brian
AU - Haque, Khalid
AU - Salt, Alison
AU - Stenson, Ben
AU - Tarnow-Mordi, William
AU - INIS Collaborative Group
AU - Greisen, Gorm
AU - Reinholdt, Jes
PY - 2011/9/29
Y1 - 2011/9/29
N2 - BACKGROUND: Neonatal sepsis is a major cause of death and complications despite antibiotic treatment. Effective adjunctive treatments are needed. Newborn infants are relatively deficient in endogenous immunoglobulin. Meta-analyses of trials of intravenous immune globulin for suspected or proven neonatal sepsis suggest a reduced rate of death from any cause, but the trials have been small and have varied in quality. METHODS: At 113 hospitals in nine countries, we enrolled 3493 infants receiving antibiotics for suspected or proven serious infection and randomly assigned them to receive two infusions of either polyvalent IgG immune globulin (at a dose of 500 mg per kilogram of body weight) or matching placebo 48 hours apart. The primary outcome was death or major disability at the age of 2 years. RESULTS: There was no significant between-group difference in the rates of the primary outcome, which occurred in 686 of 1759 infants (39.0%) who received intravenous immune globulin and in 677 of 1734 infants (39.0%) who received placebo (relative risk, 1.00; 95% confidence interval, 0.92 to 1.08). Similarly, there were no significant differences in the rates of secondary outcomes, including the incidence of subsequent sepsis episodes. In follow-up of 2-year-old infants, there were no significant differences in the rates of major or nonmajor disability or of adverse events. CONCLUSIONS: Therapy with intravenous immune globulin had no effect on the outcomes of suspected or proven neonatal sepsis. (Funded by the United Kingdom Medical Research Council and others; INIS Current Controlled Trials number, ISRCTN94984750.).
AB - BACKGROUND: Neonatal sepsis is a major cause of death and complications despite antibiotic treatment. Effective adjunctive treatments are needed. Newborn infants are relatively deficient in endogenous immunoglobulin. Meta-analyses of trials of intravenous immune globulin for suspected or proven neonatal sepsis suggest a reduced rate of death from any cause, but the trials have been small and have varied in quality. METHODS: At 113 hospitals in nine countries, we enrolled 3493 infants receiving antibiotics for suspected or proven serious infection and randomly assigned them to receive two infusions of either polyvalent IgG immune globulin (at a dose of 500 mg per kilogram of body weight) or matching placebo 48 hours apart. The primary outcome was death or major disability at the age of 2 years. RESULTS: There was no significant between-group difference in the rates of the primary outcome, which occurred in 686 of 1759 infants (39.0%) who received intravenous immune globulin and in 677 of 1734 infants (39.0%) who received placebo (relative risk, 1.00; 95% confidence interval, 0.92 to 1.08). Similarly, there were no significant differences in the rates of secondary outcomes, including the incidence of subsequent sepsis episodes. In follow-up of 2-year-old infants, there were no significant differences in the rates of major or nonmajor disability or of adverse events. CONCLUSIONS: Therapy with intravenous immune globulin had no effect on the outcomes of suspected or proven neonatal sepsis. (Funded by the United Kingdom Medical Research Council and others; INIS Current Controlled Trials number, ISRCTN94984750.).
U2 - http://dx.doi.org/10.1056/NEJMoa1100441
DO - http://dx.doi.org/10.1056/NEJMoa1100441
M3 - Journal article
SN - 0028-4793
VL - 365
SP - 1201
EP - 1211
JO - New England Journal of Medicine
JF - New England Journal of Medicine
IS - 13
ER -