Cui X, Nolen LD, Sun J, Booth M, Donaldson L, Quinn CP, Boyer AE, Hendricks K, Shadomy S, Bothma P, Judd O, McConnell P, Bower WA, Eichacker PQ. Analysis of
Anthrax Immune Globulin Intravenous with Antimicrobial Treatment in Injection Drug Users, Scotland, 2009-2010.
Emerg Infect Dis 2018;
23:56-65. [PMID:
27983504 PMCID:
PMC5176236 DOI:
10.3201/eid2301.160608]
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Abstract
We studied anthrax immune globulin intravenous (AIG-IV) use from a 2009-2010 outbreak of Bacillus anthracis soft tissue infection in injection drug users in Scotland, UK, and we compared findings from 15 AIG-IV recipients with findings from 28 nonrecipients. Death rates did not differ significantly between recipients and nonrecipients (33% vs. 21%). However, whereas only 8 (27%) of 30 patients at low risk for death (admission sequential organ failure assessment score of 0-5) received AIG-IV, 7 (54%) of the 13 patients at high risk for death (sequential organ failure assessment score of 6-11) received treatment. AIG-IV recipients had surgery more often and, among survivors, had longer hospital stays than did nonrecipients. AIG-IV recipients were sicker than nonrecipients. This difference and the small number of higher risk patients confound assessment of AIG-IV effectiveness in this outbreak.
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