Management of Neonatal Sepsis with Intravenous Immunoglobulin as an Adjunctive Therapy in Preterm Newborn

BACKGROUND Neonatal sepsis refers to systemic infections affecting infants within 28 days of life,1 characterised by invasion of bloodstream by pathogens and possible involvement of multiple organ systems. Neonatal sepsis can present as bloodstream infections (BSI) or septicaemia, pneumonia, meningitis, urinary tract, and bone / joint infections but does not as superficial infections. We wanted to evaluate the rationale of administering intravenous immune globulin (IVIG) with antimicrobials to improve the therapeutic significance of sepsis in preterm neonates. METHODS One hundred preterm neonates with sepsis were randomly assigned into study and control categories at SNCU, Department of Paediatrics, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India. Study-category was given IVIG in addition to standard treatment. RESULTS Total 100 sick new-borns were registered, 50 in study, and 50 in control categories. There were no differences in sex ratio (male 50 %, female 50 %) of sick new-borns who were registered. This was also apparent in the study (males 47.7 %, females 52.3 %) and control category (males 52.3 %, females 47.7 %). CONCLUSIONS The cause of increased morbidity and mortality in severe infection of preterm neonates was the low level of immunity. IVIG use in conjunction with the antimicrobials and other sympathetic therapy can change the end result.