Comparison of management options for specific antibody deficiency

Background: Specific antibody deficiency is a primary immunodeficiency characterized by normal immunoglobulins with an inadequate response to polysaccharide antigen vaccination. This disease can result in recurrent infections, the most common being sinopulmonary infections. Treatment options include clinical observation, prophylactic antibiotic therapy, and immunoglobulin supplementation therapy, each with limited clinical data about their efficacy. Objective: This study aimed to identify whether there was a statistically significant difference in the rate of infections for patients who were managed with clinical observation, prophylactic antibiotics, or immunoglobulin supplementation therapy. Methods: A retrospective chart review was conducted. Patients were eligible for the study if they had normal immunoglobulin levels, an inadequate antibody response to polysaccharide antigen‐based vaccination, and no other known causes of immunodeficiency. Results: A total of 26 patients with specific antibody deficiency were identified. Eleven patients were managed with immunoglobulin supplementation, ten with clinical observation, and five with prophylactic antibiotic therapy. The frequency of antibiotic prescriptions was assessed for the first year after intervention. A statistically significant rate of decreased antibiotic prescriptions after intervention was found for patients treated with immunoglobulin supplementation (n = 11; p = 0.0004) and for patients on prophylactic antibiotics (n = 5; p = 0.01). There was no statistical difference in antibiotic prescriptions for those patients treated with immunoglobulin supplementation versus prophylactic antibiotics (p = 0.21). Conclusion: Prophylactic antibiotics seemed to be equally effective as immunoglobin supplementation therapy for the treatment of specific antibody deficiency. Further studies are needed in this area.

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Animal Bites to the Head and Neck

Ear Nose & Throat Journal ◽

10.1177/014556139807700312 ◽

1998 ◽

Vol 77 (3) ◽

pp. 216-220 ◽

Cited By ~ 19

Author(s):

Stilianos E. Kountakis ◽

Socorro A. Chamblee ◽

Alberto A.J. Maillard ◽

Charles M. Stiernberg

Keyword(s):

Antibiotic Therapy ◽

Head And Neck ◽

Retrospective Review ◽

Medical Records ◽

Prophylactic Antibiotic ◽

Prophylactic Antibiotics ◽

The Other ◽

Large Teaching Hospital ◽

Prophylactic Antibiotic Therapy ◽

Animal Bites

There is controversy regarding the timing of repair and the use of prophylactic antibiotics in patients with animal bites to the head and neck. In this paper we review our experience with such wounds, and address surgical management and the use of prophylactic antibiotic therapy. A retrospective review of the medical records of 29 patients with animal bites to the head and neck was conducted. All patients were seen and treated at a large teaching hospital in Houston, Texas over an 18-month period. Seventy-six percent of our patients were 12 years old or younger. Most came to the emergency room soon after sustaining their injuries, and their wounds were repaired primarily with favorable results. There were no cases of wound infection. Ninety percent were treated with prophylactic antibiotics. The wounds of the 10% of patients who did receive antibiotics were similar to those of the other patients and healed well without infection. Wounds resulting from animal bites to the head and neck can be repaired primarily when treated shortly after injury. Further prospective, randomized studies are recommended to evaluate the effectiveness and necessity of prophylactic antibiotic therapy in this patient population.

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P240 Polysaccharide-specific antibody deficiency with intact recall of pneumococcal conjugate vaccine antigens by polysaccharide antigen

Annals of Allergy Asthma & Immunology ◽

10.1016/j.anai.2016.09.252 ◽

2016 ◽

Vol 117 (5) ◽

pp. S93-S94

Author(s):

A. Al-Kaabi ◽

J. Orange

Keyword(s):

Conjugate Vaccine ◽

Specific Antibody ◽

Pneumococcal Conjugate Vaccine ◽

Antibody Deficiency ◽

Polysaccharide Antigen ◽

Specific Antibody Deficiency ◽

Vaccine Antigens

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A Study of Antibiotic Prophylaxis in Unconscious Patients

PEDIATRICS ◽

10.1542/peds.21.2.202 ◽

1958 ◽

Vol 21 (2) ◽

pp. 202-202

Keyword(s):

Antibiotic Therapy ◽

Antibiotic Prophylaxis ◽

Prophylactic Antibiotic ◽

Treated Group ◽

Pulmonary Complications ◽

Prophylactic Antibiotics ◽

Prophylactic Therapy ◽

Gram Negative ◽

Prophylactic Antibiotic Therapy ◽

Unconscious Patients

A group of 72 comatose patients with no evidence of infection were studied in order to establish the influence of prophylactic antibiotics on their subsequent course. Of this group, 32 were treated with penicillin and streptomycin or tetracycline, and 10 received sulfisoxazole or nitrofurantoin; the remaining 30 patients served as controls and received no prophylactic therapy. It was found that there was no difference in mortality between the treated and the untreated groups. However, pulmonary complications developed in 45% of the prophylactically treated group whereas only 15% of the untreated patients developed such complications. In the treated group, bacteremia due to a gram-negative rod occurred in two patients who died. In addition, the usual nasopharyngeal flora of the treated patients was replaced by gram-negative rods. The authors conclude that "prophylactic antibiotic therapy is of no benefit, and is distinctly hazardous in unconscious patients."

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