Pediatr Allergy Respir Dis.  2010 Mar;20(1):17-22.

The Effect of Immunoglobulin as Adjuvant Therapy in Pediatric Patients with Antibiotic Ineffective Pneumonia

• Yun HJ
• Kim YH
• Hyun MC

Abstract

PURPOSE
Despite the appropriate antibiotic therapy, some patients with pneumonia do not show a significant clinical improvement. One of the important factors associated with the aggravation of pneumonia is the inflammatory response of the patient. The use of intravenous immunoglobulin (IVIG) to regulate inflammation in severe pneumonia may be beneficial. We evaluated the therapeutic effect of IVIG as an add-on therapy in patients whose pneumonia did not respond to the initial antibiotic therapy.
METHODS
This study was conducted from January 2006 to March 2009 on 14 patients admitted with pneumonia who showed persistent fever and progressive worsening of radiographic findings in spite of appropriate empirical antibiotic therapy. Immunoglobulin was administrated on the 3rd to 10th admission days (6th days on average).
RESULTS
The median age was 67 months (range 16-102 months), and 8 were female. All children received ampicillin+sulbactam+macrolide, or cefotaxime+macrolide. Acute Mycoplasma infection occurred in 64% (9/14) of the patients. The collapse and/or consolidation of the lobe was found in 50% (7/14) of the patients on chest radiograph. After IVIG administration, all patients became afebrile within 24 hrs, and their C-reactive protein and radiographic findings showed a significant improvement in several days.
CONCLUSION
Prompt IVIG therapy may be beneficial to patients with pneumonia who did not respond to the initial antibiotic therapy, especially when the use of corticosteroids is contraindicated.

Keyword

Child; Immunoglobulin; Inflammation; Pneumonia

MeSH Terms

Adrenal Cortex Hormones
C-Reactive Protein
Child
Female
Fever
Humans
Immunoglobulin A
Immunoglobulins
Immunoglobulins, Intravenous
Inflammation
Mycoplasma Infections
Pneumonia
Thorax
Adrenal Cortex Hormones
C-Reactive Protein
Immunoglobulin A
Immunoglobulins
Immunoglobulins, Intravenous