A Randomized, Double-Blind, Placebo-Controlled Trial of Prophylactic Recombinant Human Granulocyte-Macrophage Colony-Stimulating Factor to Reduce Nosocomial Infections in Very Low Birth Weight Neonates

J Pediatr. 1999 Jan;134(1):64-70. doi: 10.1016/s0022-3476(99)70373-2.

Abstract

Objective: We carried out a randomized placebo-controlled trial in very low birth weight neonates (VLBWNs), comparing the incidence of nosocomial infections after the prophylactic use of recombinant human granulocyte-macrophage colony-stimulating factor (rhu GM-CSF) versus placebo in VLBWNs.

Study design: VLBWNs (n = 264), weighing 501 to 1000 g, </=72 hours of age were randomly assigned to receive rhu GM-CSF (8 microg/kg/d), administered intravenously (n = 134) over 2 hours daily x 7 days and every other day for 21 days, or placebo (n = 130). The safety, incidence of nosocomial infections, days of absolute neutrophil count >/=4000/mm,3 peripheral blood progenitor studies, and 24-hour polymorphonuclear leukocyte C3bi receptor expression were compared between the 2 treatment groups.

Results: No (grade III/IV) toxicity or adverse events were associated with rhu GM-CSF. The absolute neutrophil count and absolute eosinophil count were significantly elevated in the rhu GM-CSF group on days 7 (P =.001), 14 (P =.001), and 21 (P =.007) and on days 7 and 28 (P =.012 and P =.001, respectively). However, there was no difference in the incidence of confirmed nosocomial infections between the 2 treatment groups in this trial (40% vs 39%, rhu GM-CSF vs placebo; P = NS).

Conclusion: In a large randomized placebo-controlled trial, prophylactic administration of rhu GM-CSF in VLBWNs does not appear to decrease the incidence of nosocomial infections.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross Infection / prevention & control*
  • Double-Blind Method
  • Eosinophils / drug effects
  • Female
  • Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use*
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Injections, Intravenous
  • Leukocyte Count / drug effects
  • Male
  • Recombinant Proteins
  • United States

Substances

  • Recombinant Proteins
  • Granulocyte-Macrophage Colony-Stimulating Factor