Effectiveness of Immunoglobulins for the Prevention of Systemic Infections

Abstract

The prophylactic administration of immunoglobulins to preterm neonates has a controversial effectiveness in reducing the incidence of nosocomial infections. Since the clinical trials conducted so far have given conflicting results, a metaanalysis was carried out to summarise the overall information presently available on this issue. Eight randomised clinical trials were identified by our literature search that met the inclusion criteria of our meta-analysis. In each study, the effectiveness of intravenous immunoglobulins was compared with that of no treatment or placebo. The overall number of patients included in our metaanalysis was 3739. The end-point was the incidence of proven infections. The results of our meta-analysis demonstrate that prophylactic immunoglobulins significantly reduced the incidence of proven infections (pooled odds ratio = 0.79, 95% CI: 0.69 to 0.91; p = 0.0014; reduction in the incidence of infection from 23.2 to 19.3%). There was, however, a significant intertriai heterogeneity. A cost-effectiveness analysis indicated that the prophylactic administration of immunoglobulins implies a cost of approximately $US8000 to prevent each case of infection in premature infants. This cost seems to be at least equal to the cost of treating an episode of sepsis in an infant.