Intravenous Immunoglobulin in the Treatment of Salmonella Typhimurium Infections in Preterm Neonates

The purpose of this study was to determine the role of intravenous immunoglobulin (IVIG) administration in preterm neonates with S. typhimurium infection. A randomized trial of 47 preterm neonates with intestinal or extraintestinal S. tymphimurium infection was performed. Neonates were randomly divided into two groups: 22 neonates were only given cefoperazone (group 1); 25 neonates were given cefoperazone plus IVIG (group 2). IVIG was given at a dose of 500 mg/kg on days 1, 2, 3, and 8 after entry into the study. Following treatment, bacteremia, complications, mortality rate, recovery time, and duration of antimicrobial therapy were evaluated in two groups. Bacteremia was found in 31.4% in group 1 and 8% in group 2 ( P<.05); complications developed in 81.8% in group 1 and 16% in group 2 ( P<0.01); mortality was 40.9% in group 1 and 12% in group 2 ( P<.05). Recovery took 15 days in group 1 and 8 days in group 2 (P < .01). The duration of antimicrobial therapy was 20 days in group 1 and 14 days in group 2 ( P<.01). We conclude that IVIG treatment in combination with antibiotics in preterm neonates with S. typhimurium infection reduces the complications, mortality rate, and duration of therapy.