IVIG administration results in a 3% reduction in sepsis and a 4% reduction in one or more episodes of any serious infection but is not associated with reductions in other clinically important outcomes, including mortality. Prophylactic use of IVIG is not associated with any short-term serious side effects.
The decision to use prophylactic IVIG will depend on the costs and the values assigned to the clinical outcomes. There is no justification for conducting additional RCTs to test the efficacy of previously studied IVIG preparations in reducing nosocomial infections in preterm and/or LBW infants.
Intravenous immunoglobulin prophylaxis for infection in very low birth-weight infants.
The effectiveness of intravenous immunoglobulin for prevention of sepsis in very low birth weight infants was studied on 102 neonates at the Children Hospital, Bangkok from February 1988 to February 1990. Infants were randomly allocated into 3 groups of 35 each. Group I and group II received 250 mg/kg and 500 mg/kg of immunoglobulin intravenously respectively within four hours of life. Group III was not given immunoglobulin and served as the control group. It was found that during the early neonatal period the infection rate of group I (14.7%) and group II (14.7%) was significantly lower than that of group III (38.2%). There was no difference in the infection rate of group I and group II. The mortality rate was also higher in group III than in group I and group II. It suggested that the intravenous immunoglobulin dosage of 250 mg per kilogram body weight is effective as well as dosage of 500 mg per kilogram body weight in prevention of sepsis in very low birth weight infants during the early neonatal period.