We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Role of intravenous immune globulin in streptococcal toxic shock syndrome and Clostridium difficile infection.
- Authors
Shah, Punit J.; Vakil, Niyati; Kabakov, Anna
- Abstract
Purpose. The use of intravenous immune globulin (IVIG) in the management of streptococcal toxic shock syndrome (STSS) and Clostridium difficile infection (CDI) is reviewed. Summary. IVIG has a wide range of uses in clinical practice, including STSS and CDI. It is an attractive option for these two infections because both infections are toxin mediated, and IVIG may contain antibodies that neutralize these toxins. For STSS and CDI, IVIG is often considered for use in critically ill patients who are not responding to traditional therapies. Several encouraging case reports and retrospective chart reviews have been published, highlighting the potential benefit of IVIG in such patients. However, its definitive role remains unclear, mainly due to the lack of high-level evidence. Data supporting its use have been extrapolated from retrospective chart mediated, and IVIG may contain antibodies that neutralize these toxins. IVIG for STSS and CDI is usually administered to critically ill patients who are not responding to standard reviews and case reports in which profound heterogeneity in patient populations and treatment modalities exist. The use of IVIG must be weighed carefully because it is not a benign product. As with the use of IVIG for STSS, the role of IVIG for CDI is unclear. Nonetheless, IVIG may serve as a useful adjunct therapy for patients suffering from severe complicated CDI (shock, ileus, or megacolon) who do not respond to conventional treatment. Adverse reactions to IVIG are mild and transitory and occur during or immediately after drug infusion. Conclusion. Although randomized, controlled trials supporting the use of IVIG for STSS and CDI are lacking, IVIG may be considered a last-line adjunct therapy in those patients for whom the clinical benefit outweighs the potential adverse effects of therapy.
- Subjects
CLOSTRIDIUM disease treatment; CLOSTRIDIOIDES difficile; COST effectiveness; IMMUNOGLOBULINS; STREPTOCOCCUS; TOXIC shock syndrome; UNITED States. Food &; Drug Administration; ADVERSE health care events; IN vitro studies
- Publication
American Journal of Health-System Pharmacy, 2015, Vol 72, Issue 12, p1013
- ISSN
1079-2082
- Publication type
Article
- DOI
10.2146/ajhp140359