Efficacy of recombinant human granulocyte colony stimulating factor in very-low-birth-weight infants with early neutropenia

Abstract

Neutropenia is a risk factor for nosocomial infections (NI) in very-low-birth-weight (VLBW) infants. Although recombinant human granulocyte colony stimulating factor (rhG-CSF) increases the neutrophil counts in neutropenic VLBW infants, its long-term efficacy for early neutropenia (EN) remains unknown. Methods: In this case-controlled study, charts of VLBW recipients of rhG-CSF for EN (total neutrophil count <1.5 × 109/L during first 7 days) were reviewed and compared to gestational age, total neutrophil count, and birth weight matched infants unexposed to rhG-CSF. Results: Twenty-seven infants were identified in each group. Mortality and morbidity did not differ between the two groups. Rate of NI (16/27 vs. 4/27, p = 0.002, odds ratio = 8.36) as well as the total number of episodes of NI (22 vs. 4, p = 0.007) were higher in rhG-CSF (+) group than in the rhG-CSF (–) group. Conclusion: Our experience does not show benefit in empirical use of rhG-CSF in preventing NI in VLBW infants with EN.

Keywords

• granulocyte-colony-stimulating-factor
• neutropenia
• nosocomial infection
• very-low-birth-weight