Journal
PEDIATRIC INFECTIOUS DISEASE JOURNAL
Volume 21, Issue 11, Pages 1061-1065Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/00006454-200211000-00017
Keywords
recombinant granulocyte colony-stimulating factor; recombinant human granulocyte-macrophage colony-stimulating factor; neonatal sepsis; absolute neutrophil count; neutropenia
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Funding
- NCRR NIH HHS [M01-RR-06020] Funding Source: Medline
- NIAID NIH HHS [K08-AI01422] Funding Source: Medline
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Background. To reduce morbidity and mortality adjuvant cytokine therapy was administered to septic neonates with variable results. The objective of this case series was to compare the effectiveness of recombinant human granulocyte-macrophage colony-stimulating factor (rhuGM-CSF) and recombinant granulocyte colony-stimulating factor (rG-CSF) with that of placebo in correcting neutropenia induced by sepsis. Methods. Symptomatic, septic premature neonates with or without a positive blood culture were eligible. Twenty-eight patients were randomized: 10 received rG-CSF (5 mug/kg/dose iv twice a day); 10 received rhuGM-CSF (4 mug/kg/dose iv twice a day) and 8 received placebo for a maximum of 7 days, or until an absolute neutrophil count (ANC) of 10 000 cells/mm(3) was reached. Results. A significant increase in the ANC above the baseline was present on Day 2 in the rG-CSF group (P = 0.015) and on Day 5 in the rhuGM-CSF (P = 0.002) and placebo (P = 0.027) groups. The ANC of the rG-CSF group was significantly above that in the rhuGM-CSF and placebo groups on Day 7 (P = 0.03). Mortality and neonatal intensive care unit morbidity was not significantly different between the groups. Conclusion. The neutrophil count in the rGCSF-treated group increased significantly faster than that in the placebo or rhuGM-CSF group.
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