Effect of interferon gamma on infection-related death in patients with severe injuries. A randomized, double-blind, placebo-controlled trial
D. J. Dries, G. J. Jurkovich, R. V. Maier, T. P. Clemmer, S. N. Struve, J. A. Weigelt, G. G. Stanford, D. L. Herr, H. R. Champion, F. R. Lewis and al. et
Department of Surgery and Shock Trauma Institute, Loyola University Medical Center, Maywood, Ill.
OBJECTIVE: To assess the efficacy of interferon gamma in reducing infection
and death in patients sustaining severe injury. DESIGN: Multicenter,
randomized, double-blind, placebo-controlled trial with observation for 60
days and until discharge for patients with major infection on day 60.
SETTING: Nine university-affiliated level 1 trauma centers. PATIENTS: Four
hundred sixteen patients with severe injuries, assessed by Injury Severity
Score and degree of contamination. INTERVENTION: Recombinant human
interferon gamma, 100 micrograms, was administered subcutaneously once
daily for 21 days (or until patient discharge if prior to 21 days) as an
adjunct to standard antibiotic and supportive therapy. MAIN OUTCOME
MEASURES: Incidence of major infection, death related to infection, and
death. RESULTS: Infection rates were similar in both treatment groups;
however, patients treated with interferon gamma experienced fewer deaths
related to infection (seven [3%] vs 18 [9%]; P = .008) and fewer overall
deaths (21 [10%] vs 30 [14%]; P = .17). While 12 early deaths (days 1
through 7) occurred in each treatment group, late death occurred in 18
placebo-treated patients and nine in interferon gamma-treated patients. The
results were dominated by findings at one center, which had the highest
enrollment and higher infection and death rates. Statistical analysis did
not eliminate the possibility of an unidentified imbalance between arms as
an explanation for the results. CONCLUSION: Further evaluation is required
to determine the validity of the observed reduction in infection-related
deaths in patients treated with interferon gamma.
Statins and sepsis
Gao et al.
Br J Anaesth 2008;100:288-298.
ABSTRACT
| FULL TEXT
Pathophysiology of Sepsis
Remick
Am. J. Pathol. 2007;170:1435-1444.
ABSTRACT
| FULL TEXT
Reprogramming of circulatory cells in sepsis and SIRS
Cavaillon et al.
Innate Immunity 2005;11:311-320.
ABSTRACT
Interferon-{gamma} increases monocyte HLA-DR expression without effects on glucose and fat metabolism in postoperative patients
de Metz et al.
J. Appl. Physiol. 2004;96:597-603.
ABSTRACT
| FULL TEXT
Prevention of nosocomial bacterial pneumonia
Vincent
Thorax 1999;54:544-549.
FULL TEXT
Hyporesponsiveness in leukocytes in sepsis: in vitro models reveal paradoxical effects of IL-10
Cavaillon et al.
Innate Immunity 1999;5:81-85.
ABSTRACT
Inhibition of the Defense System Stimulating Interleukin-12 Interferon-gamma Pathway During Critical Illness
Ertel et al.
Blood 1997;89:1612-1620.
ABSTRACT
| FULL TEXT
The clinical significance of endotoxin released by antibiotics: what is the evidence?
Mock et al.
Innate Immunity 1996;3:253-259.
ABSTRACT
Preclinical and clinical evaluation of carbohydrate immunopharmaceuticals in the prevention of sepsis and septic sequelae
Williams et al.
Innate Immunity 1995;2:203-208.
ABSTRACT
