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Objective: This study aimed to compare the clinical and laboratory outcomes and the mortality rate of neonatal sepsis treated with antibiotics and IgM-enriched IVIG as adjunctive therapy versus antibiotic alone. In addition, this study aimed to determine the morbidities and safety following the IgM-enriched IVIG treatment.
Materials and Methods: A retrospective cohort study was conducted between January 2016 to December 2018 in Naresuan University Hospital, Thailand. All eligible neonates were divided into 2 groups. The control group received antibiotics alone. The intervention group received both antibiotics and IgM-enriched IVIG. The clinical, laboratory parameters and morbidities were collected and compared.
Results: There were 28 neonates enrolled in the study. There were 14 in each group. In the intervention group, after receiving the 3-day course of IgM-enriched IVIG concurrently with antibiotics, the patients had significantly decreased respiratory rates (p=0.022), increased mean arterial pressure (p=0.049) and increased serum pH (p=0.017). The incidence of necrotizing enterocolitis and patent ductus arteriosus was lower in the intervention group (p=0.038 and p=0.001, respectively). No adverse effects recorded.
Conclusion: The use of IgM-enriched IVIG as adjunctive treatment showed evidence of improved outcome in the treatment of neonatal sepsis in some clinical and laboratory parameters. it also reduced morbidities in neonates presented with hypotension and DIC.
Keywords: Neonatal sepsis, Intravenous IgM-enriched IVIG, Intravenous immunoglobulin, Antibiotics
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