A controlled clinical trial of E5 murine monoclonal IgM antibody to endotoxin in the treatment of gram-negative sepsis

Article Abstract:

Bacterial infections are not uncommon in hospitals and are an important cause of death. Gram-negative bacteria may infect the bloodstream of from 10 to 15 per 1,000 hospital patients; these bacteria contain complex substances called endotoxins in their cell walls which induce complex and dangerous responses in the patient. Such Gram-negative infection of the blood, also called Gram-negative bacteremia, is fatal in from 21 to 31 percent of cases. It has always been considered possible to neutralize the effects of endotoxins with antibodies. However, until the advent of monoclonal antibody techniques, there has been no large-scale source of such antibodies. A study was undertaken to determine if monoclonal antibodies, obtained from mouse cells, may prove clinically useful in neutralizing endotoxin. Three hundred sixteen patients developed Gram-negative sepsis over a 30-day period (in sepsis, the endotoxin is present in the blood, regardless of whether the bacteria are detectable in the blood or not). Patients were randomly assigned to receive either the mouse antibody or placebo, in addition to their other treatment. Among the patients who had already gone into toxic shock, the antibody treatment provided no significant benefit. However, among the 137 patients who were not in shock, the patients receiving the antibody had 2.3 times less risk of dying than the patients who received placebo. Organ failure is a common complication of Gram-negative sepsis. Among the patients not in shock, organ failure resolved in 19 of 35 patients treated with the antibodies and in only eight of 27 patients receiving placebo. The results of the study indicate that if a patient with Gram-negative sepsis has not yet gone into shock, antibodies against endotoxin provide a superior level of protection. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Care and treatment, Gram-negative bacteria, Endotoxins, Antitoxins, Septicemia

---

The direct costs of universal precautions in a teaching hospital

Article Abstract:

The AIDS epidemic has prompted the Centers for Disease Control (CDC) to recommend new procedures for the handling of blood and blood fluids by medical personnel. CDC has called for the universal use of a barrier system that relies upon rubber gloves, protective gowns, disposable face masks, reusable pocket masks, protective eye wear and disposable containers for sharp disposable objects such as needles and blades. The cost for instituting such a universal protection system was documented at the University of Iowa Hospitals and Clinics, a 900-bed teaching and research institution Iowa City, Iowa. The institution admits approximately 33,700 patients yearly, and an additional 400,000 outpatients are seen annually. The costs of consumable materials used as a barrier over the previous five-year period were compared with those in the year following the establishment of barrier precautions. For this facility, the total costs for these materials increased by $350,900 annually, or $22.89 per hospital admission. Approximately 66 percent of the increase was due to the provision of rubber gloves, and 25 percent to disposable isolation gowns. (Consumer Summary produced by Reliance Medical Information, Inc.)

Economic aspects, Finance, Prevention, Social policy, Communicable diseases, Rubber gloves, Preventive medicine, Gloves (Surgery), Medicine, Preventive, United States. Centers for Disease Control and Prevention, Surgical gowns

---

Expanding the Treatment Options for Influenza

Article Abstract:

Neuraminidase inhibitors are an expensive but effective treatment for influenza. These drugs prevent the influenza virus from spreading from one infected cell and infecting others. Zanamivir and oseltamivir are two neuraminidase inhibitors that are available for the treatment of flu. A study showed that people with the flu who took oseltamivir recovered about one day sooner than those who took a placebo. This would translate to 254 fewer hours of illness per 1,000 patients treated and 544 fewer hours of lost activity per 1,000 patients treated. As of Feb, 2000, a five-day supply of the drug costs $50.

Editorial, Evaluation, Drug therapy, Influenza, Antiviral agents

Similar abstracts:

• Abstracts: Pilot randomized controlled trial of Chinese herbal treatment for HIV-associated symptoms. Human herpesvirus 8 oral shedding in HIV-infected men with and without Kaposi Sarcoma
• Abstracts: Are we ready for clinical gene therapy? Placing health promotion into the context of our lives. Health promotion made easy -- give a gift!
• Abstracts: Sports participation, age at smoking initiation, and the risk of smoking among US high school students. Trends in Pregnancy-Related Smoking Rates in the United States, 1987-1996
• Abstracts: Medical malpractice and the tort system. Conflicts of interest: physician ownership of medical facilities. ERISA Litigation and Physician Autonomy
• Abstracts: Subsequent Sexually Transmitted Infections Among Adolescent Women With Genital Infection Due to Chlamydia trachomatis, Neisseria gonorrhoeae, or Trichomonas vaginalis

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.