A single intravenous infusion of gamma globulin as compared with four infusions in the treatment of acute Kawasaki syndrome

Article Abstract:

Kawasaki disease (also known as mucocutaneous lymph node syndrome) is a childhood disease which involves lymph node abnormalities, fever, rash, inflammation of the conjunctiva covering the eyelids, and the inflammation of mucous membranes. Since the cause of Kawasaki disease is not known, the diagnosis must be made only after carefully excluding other causes of these symptoms. It is widely suspected that Kawasaki disease results from some as-yet unidentified infection. Children with Kawasaki disease may develop inflammation of arteries as well, which can result in damage to the coronary arteries, which supply the heart, and subsequent heart disease. The disease is usually treated with aspirin, which reduces the fever and some of the inflammation, and with human immunoglobulin, or antibodies. It is uncertain how human antibodies help prevent complications of Kawasaki disease, but one theory is that the extra antibodies block some adverse effects caused by the complexes of the patient's antibodies with foreign antigens. The current treatment consists of four consecutive daily doses of intravenous human immunoglobulin; this treatment has been conclusively shown to reduce the rate of damage to the coronary arteries. Since it is desirable to reduce the length of stay in the hospital without compromising a patient's health, a test was conducted to determine whether a single large dose might be just as effective as four daily doses. In a prospective trial involving 549 children with Kawasaki disease, the patients were randomly assigned to receive either a single dose or daily doses; the results indicated that the large single dose is actually more effective than the daily doses and appears to be equally safe. The children receiving the single dose had a lower temperature and shorter duration of fever. In addition, laboratory measurements indicated that acute inflammation resolved more rapidly in children treated with the single dose. Congestive heart failure, either as a new condition or as a worsening of a preexisting condition, affected nine patients, six in the single-dose group and three in the daily dose. This difference between the groups was not considered to be significant. (Consumer Summary produced by Reliance Medical Information, Inc.)

Kawasaki disease, Kawasaki syndrome

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Intravenous immune globulin for the prevention of nosocomial infection in low-birth-weight neonates

Article Abstract:

Intravenous immune globulins, or antibodies, may prevent nosocomial infections in premature infants. Premature infants with a very low birth weight may have a higher risk for nosocomial, or hospital-acquired infections, because they have lower blood levels of antibodies. Of 584 premature infants who weighed between 500 and 1,750 grams at birth, 287 were treated were intravenous immune globulin and 297 were treated with a placebo, an inactive substance. Infants treated with intravenous immune globulin had a significantly lower risk of a first nosocomial infection, compared with those who received a placebo. Infants in the immune globulin group were hospitalized an average of 62 days, compared with an average of 68 days among those in the placebo group. Five infants in each treatment group experienced mild side effects.

Infants (Premature), Birth weight, Low, Premature infants, Low birth weight, Nosocomial infections, Cross infection

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Prevention of infective endocarditis: guidelines from the American Heart Association

Article Abstract:

The recommendations of American Heart Association on preventing and treating infective endocarditis using antibiotic prophylaxis are presented.

United States, Services information, Usage, Services, Antibiotics, American Heart Association, Infective endocarditis, Antibiotic prophylaxis

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