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document
Specific immunoglobulin for treatment of whooping cough . Immunoglobulin treatment for whooping cough ( pertussis ) is widely believed to be ineffective although there are sound reasons for regarding the condition as a toxin-induced disease . We wondered whether the lack of success with pertussis immunoglobulins might be attributable to inadequate dose , so we designed a randomised , double-blind , placebo-controlled trial of two immunoglobulin preparations . The study was conducted at three Swedish hospitals . We enrolled 73 children aged less than 36 months who were admitted with a clinical diagnosis of whooping cough . On admission they were assigned to one of three groups : ( a ) monocomponent pertussis toxoid vaccine ; ( b ) two-component acellular vaccine also containing filamentous haemagglutinin ; or ( c ) 20 % albumin solution ( placebo ) . The immunoglobulins had a high antitoxin content and had been raised with acellular pertussis vaccines . Diagnosis of pertussis was confirmed by laboratory tests and the follow-up was completed in 67 children . The main study group consisted of 47 children with less than or equal to 14 days of disease before therapy . Duration of whoops post-treatment was 8.7 days ( 95 % Cl 4.8 , 12.6 ) in the 33 children receiving immunoglobulin vs 20.6 ( 95 % Cl 11.9 , 29.3 ) in the 14 receiving placebo ( p = 0.0041 ) . Mean number of whoops during the first week of follow-up was also significantly reduced ( p = 0.0196 ) . We found that early treatment was important , since the effect on duration of whoops was most pronounced when disease duration before treatment was less than or equal to 7 days . There were no significant differences between the two immunoglobulin preparations . High-dose specific pertussis immunoglobulin with a high antitoxin concentration has a beneficial effect in the treatment of whooping cough .
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Intervention_Physical
Specific immunoglobulin
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Intervention_Physical
Immunoglobulin
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Intervention_Physical
immunoglobulins
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
monocomponent pertussis toxoid vaccine
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Intervention_Pharmacological
two-component acellular vaccine also containing filamentous haemagglutinin
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Intervention_Control
20 %
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Intervention_Pharmacological
albumin solution
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Intervention_Control
( placebo )
26986
Intervention_Physical
immunoglobulins
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Intervention_Physical
immunoglobulin
26988
Intervention_Control
placebo
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Intervention_Physical
immunoglobulin
26990
Outcome_Other
ineffective
26991
Outcome_Other
lack of success
26992
Outcome_Physical
Duration of whoops post-treatment
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Outcome_Physical
Mean number of whoops
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Outcome_Other
beneficial effect
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Participant_Condition
whooping cough
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Participant_Sample-size
73
26997
Participant_Age
children aged less than 36 months
26998
Participant_Condition
whooping cough
26999
Participant_Sample-size
47
27000
Participant_Age
children
27001
Participant_Condition
less than or equal to 14 days of disease before therapy