Clinical evidence for immunologic treatment in newborn infants with sepsis

Objective Neonatal sepsis (NS) is one of the main causes of neonatal death. Immune therapy is an important way in the comprehensive treatment of NS. This study investigated several databases in order to find the clinical evidence for the immunological treatment of neonatal sepsis (NS), and to explore its clinical application value. Methods Systematic reviews and randomized (or quasi-randomized) controlled trials (RCT) for immunological treatment of NS in newborn infants were searched from the databases of MEDLINE, EMBASE and Cochrane Library.The relevant literatures were statistically analyzed. Results Six systematic reviews (including 37 RCTs) were found to be involved in the therapy, and the drugs included intravenous immunoglobulin (containing high level of IgM), antistaphylococcal immunoglobulins, neutrophile granulocyte, granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, pentoxifylline and glutamine.Pentoxifylline could decrease the mortality(Z=2.71, P=0.006 8), shorten the hospitalization(Z=2.01, P=0.044), and reduce the incidence rate of necrotizing enterocolitis (NEC)(Z=1.67, P=0.095) of the NS infants.No therapeutic effect was found for other drugs in the treatment of NS. Conclusions Current clinical evidence for the immunological treatment of NS indicates that only Pentoxifylline could decrease the mortality, reduce the incidence rate of NEC and shorten the hospitalization of infants with NS.However, current evidence is only a small scale sampling and lacks multicenter studies.Researchers are encouraged to undertake large scale and well-designed multicenter trials to confirm the effectiveness of the immunological treatment of NS. Key words: Sepsis; Immunological treatment; Systematic review; Newborn infant