Role of Intravenous Immunoglobulin (IVIG) as an Adjuvant in the Treatment of Neonatal Sepsis in Preterm Babies

Neonates are considered immunocompromised in view of their relatively immature immune defense mechanisms. Intravenous immunoglobulin (IVIG), in combination with antibiotic therapy in sepsis, has been reported to decrease the mortality and morbidity in preterm neonates. Sixty preterm neonates with sepsis were randomly assigned into study and control groups. Study-group was given IVIG in addition to standard treatment. The outcome measures were immunoglobulin levels before and after IVIG therapy in study-group, duration of hospital stay and mortality rate between the groups. IgG level was 529.16 ± 147.73 mg/dl and 886.83 ± 120.73 mg/dl; IgM 7.74 ± 2.14 mg/dl and 11.08 ± 2.84 mg/dl, and IgA 5.34 ± 2.24 mg/dl and 9.28 ± 3.26 mg/dl before and after IVIG infusion. This difference wasfound statistically significant (p 0.0001). The mean duration of hospital stay of study and control group was 14. 53 ± 3.88 days and 18.30 ± 6.88 days respectively. This difference was also statistically significant (p 0.05). The mortality rate was much lower in study group (13.3 %) compared to the control group (33.3%). Low levels of immunity in preterm neonates results in increased morbidity and mortality in severe infection. Use of IVIG along with the antibiotics and other supportive therapy can improve the outcome.