Treatment of neonatal sepsis with intravenous immune globulin

Brocklehurst, Peter, Farrell, Barbara, King, Andrew, Juszczak, Edmund, Darlow, Brian, Haque, Khalid, Salt, Alison, Stenson, Ben, Tarnow-Mordi, William, The INIS Collaborative Group and Pritchard, Margo Anne (2011) Treatment of neonatal sepsis with intravenous immune globulin. New England Journal of Medicine, 365 13: 1201-1211. doi:10.1056/NEJMoa1100441

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Author Brocklehurst, Peter
Farrell, Barbara
King, Andrew
Juszczak, Edmund
Darlow, Brian
Haque, Khalid
Salt, Alison
Stenson, Ben
Tarnow-Mordi, William
The INIS Collaborative Group
Pritchard, Margo Anne
Title Treatment of neonatal sepsis with intravenous immune globulin
Journal name New England Journal of Medicine   Check publisher's open access policy
ISSN 0028-4793
Publication date 2011-09-01
Year available 2011
Sub-type Article (original research)
DOI 10.1056/NEJMoa1100441
Open Access Status File (Publisher version)
Volume 365
Issue 13
Start page 1201
End page 1211
Total pages 11
Place of publication Waltham, MA, United States
Publisher Massachusetts Medical Society
Language eng
Formatted abstract
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.).
Keyword Preterm Infants
Q-Index Code CX
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Mater Research Institute-UQ (MRI-UQ)
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