Cohen-Wolkowiez Michael, Benjamin Daniel K, Capparelli Edmund
Department of Pediatrics, Duke University, Durham, NC 27715, USA.
Curr Opin Pediatr. 2009 Apr;21(2):177-81. doi: 10.1097/MOP.0b013e32832925e5.
Systemic infections in premature and term infants cause significant morbidity and mortality in spite of appropriate antimicrobial therapy. Consequently, immunotherapy has emerged as a potential adjuvant therapeutic modality to reduce the incidence and mortality associated with neonatal sepsis.
The most recent findings during the review period include systematic reviews of previously published trials evaluating the use of intravenous immunoglobulin and colony-stimulating factors in neonatal sepsis. In addition, the most recent trials describing the use of antistaphylococcal antibodies, probiotics, glutamine supplementation, recombinant human protein C, and lactoferrin in the prevention and treatment of neonatal sepsis have been reviewed.
Immunotherapy used as an adjuvant for the prevention and treatment of neonatal sepsis holds promise. Clinical trials specifically designed toward the neonatal population and appropriately powered to detect treatment differences are necessary prior to universal recommendation of these therapies in the nursery.
尽管进行了适当的抗菌治疗,但早产和足月婴儿的全身性感染仍会导致显著的发病率和死亡率。因此,免疫疗法已成为一种潜在的辅助治疗方式,以降低新生儿败血症的发病率和死亡率。
在综述期间的最新发现包括对先前发表的评估静脉注射免疫球蛋白和集落刺激因子在新生儿败血症中应用的试验进行系统评价。此外,还综述了描述抗葡萄球菌抗体、益生菌、谷氨酰胺补充剂、重组人蛋白C和乳铁蛋白在预防和治疗新生儿败血症中应用的最新试验。
免疫疗法作为预防和治疗新生儿败血症的辅助手段具有前景。在托儿所普遍推荐这些疗法之前,需要专门针对新生儿群体设计并具有足够效力以检测治疗差异的临床试验。