Role of Pentoxifylline and/or IgM-Enriched Intravenous Immunoglobulin in the Management of Neonatal Sepsis

Arzu Akdag; Ugur Dilmen; Khalide Haque; Dilek Dilli; Omer Erdeve; Tuelin Goekmen

doi:10.1055/s-0033-1363771

American Journal of Perinatology, Table of Contents

Am J Perinatol 2014; 31(10): 905-912
DOI: 10.1055/s-0033-1363771

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Role of Pentoxifylline and/or IgM-Enriched Intravenous Immunoglobulin in the Management of Neonatal Sepsis

Arzu Akdag

¹Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital Ankara, Turkey

,

Ugur Dilmen

¹Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital Ankara, Turkey

,

Khalide Haque

²Department of Paediatrics, Taibah University, Taibah University Medina, Medina, Saudi Arabia

,

Dilek Dilli

¹Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital Ankara, Turkey

,

Omer Erdeve

¹Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital Ankara, Turkey

,

Tuelin Goekmen

¹Department of Neonatology, Zekai Tahir Burak Maternity and Teaching Hospital Ankara, Turkey

› Author Affiliations

Abstract

Objective To investigate the effectivity of pentoxifylline (PTX) and immunoglobulin M (IgM)-enriched intravenous immunoglobulin (IVIG) therapy in the treatment of neonatal sepsis (NS), alone or in combination.

Study design This was a prospective, double-blind, controlled study. Newborns with suspicion of sepsis were enrolled in the study. The patients were separated into four groups according to treatment protocol: Group 1 = placebo, Group 2 = pentoxifylline, Group 3 = IgM-enriched IVIG, and Group 4 = pentoxifylline + IgM-enriched IVIG. Blood samples were taken for C-reactive protein, interleukin-6, neutrophil CD64 expression, and tumor necrosis factor-alfa measurements immediately before treatment (1st day), and measurements were repeated on the 2nd and 4th days of the therapy.

Results A total of 204 patients, 51 in each group, were recruited into the study. There were no significant differences for symptoms of sepsis among groups, except lethargy. No significant differences were observed among the groups according to laboratory data. Overall mortality rate was 8.8%. The rates of morbidities and mortality among study groups were similar.

Conclusion PTX and IgM-enriched IVIG therapies, either alone or in combination, did not reduce the rates of morbidities and mortality in NS.

Keywords

sepsis - newborn - pentoxifylline - IgM-enriched intravenous immunoglobulin

Full Text

References

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