Abstract
Despite optimal antibiotic therapy, H. influenzae b (Hib) meningitis often causes permanent sequelae and occasionally death. We examined the efficacy of immune globulin (IG) therapy alone or in combination with antibiotic therapy in ihe infant rat model of Hib infection. Two IG preparations were used: (1) Sandoglobulin (IVIG), at 5% protein, containing 25μg PRP Ab/ml and (2) Bacterial Polysaccharide Immune Globulin (BPIG) prepared from donors immunized with Hib vaccine, at 16% protein containing 450 μg PRP Ab/ml. Infant rats were challenged with 103 Hib ip resulting in 99% bacteremia and 88% meningitis at 18h. Therapy (Rx) given sc was Ceftriaxone (CEF; 75mg/kg qd), IVIG (15ml/kg qd), BPIG (15ml/kg qd) and combinations of CEF + IG's. Blood and CSF were cultured 24h and 72h after Rx.
CEF was highly efficacious at clearing bacteremia and meningitis and reducing mortality (p<0.01). BPIG alone but not IVIG alone cleared bacteremia; neither cleared meningitis. Both IG's produced more early deaths than saline, and IVIG + CEF resulted in higher mortality than CEF alone. We conclude that IG alone had poor efficacy in the therapy of Hib infection and may increase the early mortality rate. In addition, IVIG + CEF is less efficacious than CEF alone in the treatment of Hib infection in rats.
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Schreiber, J., Basker, C., Priehs, C. et al. DELETERIOUS EFFECT OF IMMUNE GLOBULIN IN THE TREATMENT OF H. INFLUENZAE B INFECTION IN INFANT RATS. Pediatr Res 21 (Suppl 4), 334 (1987). https://doi.org/10.1203/00006450-198704010-00999
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DOI: https://doi.org/10.1203/00006450-198704010-00999
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