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M94A2821.TXT
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1994-10-25
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Document 2821
DOCN M94A2821
TI Intra-venous gammaglobulin: a weapon against bacterial infections in HIV
infected children?
DT 9412
AU Della Negra M; Castro IO; Queiroz W; Yu CL; Soraggi Neto C; Paste AA;
Vazquez CM; Inst. Infectol. Emilio Ribas, Sao Paulo, Brazil.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):217 (abstract no. PB0297). Unique
Identifier : AIDSLINE ICA10/94369754
AB OBJECTIVE: To evaluate the effects of discontinuity of the
administration of intra-venous Gamma globulin (IVGG) and the possibility
of the use of Trimethoprim-Sulfamethoxazole (TMP-SMZ) in the prevention
of bacterial infections among pediatric AIDS patients. METHODS: In our
service, 80 pediatric AIDS patients (P2-CDC) with CD4 count > 200/mm3
receive IVGG monthly (500mg/kg). Some of them receive also TMP-SMZ (20
mg/Kg daily) as chemoprophylaxis for Pneumocystis carinii Pneumonia. For
reasons beyond our control there was a break in the supply of IVGG for 3
consecutive months in 1993. We analyzed the changes in the occupation
rate of the 12 hospital beds bound for Pediatric AIDS Patients 3 months
before, during the cessation of IVGG and 3 months after the
re-establishment of its administration. We also analyzed if the patients
who got bacterial infections during the lack of IVGG were receiving or
not TMP-SMZ. RESULTS: The occupation rate of the beds of the Pediatric
ward increased from 18.1% in the 3 months before the lack of IVGG to
50.4% during its cessation and 35.8% in the 3 months after the
re-establishment of the supply of IVGG. These rates follow the same
pattern when analyzing only the hospitalizations due to bacterial
infections. More than half of the children who got bacterial infections
were receiving TMP-SMZ. Severe bacterial infections (as septicemia,
meningitis, etc.) were infrequent during all this study. DISCUSSION: The
break in the supply of IVGG changed significantly the occupation rate in
the pediatric ward in our center. These registers did not reach the
baseline because it took some time to reestablish our routine after the
replacement of IVGG administration. It seemed clear that the use of
TMP-SMZ did not show a significant role in the prevention of bacterial
infections. Otherwise, TMP-SMZ could be the responsible for the absence
of severe bacterial infections. A better cost analysis comparing IVGG
administration and hospitalization should be done. Despite the high
cost, we believe that IVGG can provide them a better quality of life.
DE AIDS-Related Opportunistic Infections/PREVENTION & CONTROL Bacterial
Infections/COMPLICATIONS/*PREVENTION & CONTROL Bed Occupancy Child
Drug Evaluation Human HIV Infections/*COMPLICATIONS/IMMUNOLOGY
Immunoglobulins, Intravenous/ADMINISTRATION & DOSAGE/ECONOMICS/
*THERAPEUTIC USE Pneumonia, Pneumocystis carinii/PREVENTION & CONTROL
Quality of Life Trimethoprim-Sulfamethoxazole Combination/THERAPEUTIC
USE MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).