A analysis of Anthrax Immune Globulin IV use during the 2009-2010 anthrax outbreak in injection drug users in Scotland

我们分析了迄今为止在注射吸毒者中爆发的炭疽杆菌软组织感染中使用炭疽免疫球蛋白静脉注射(AIG-IV)的最大临床经验，并比较了15名AIG-IV接受者和28名非接受者的结果。总体而言，与接受者和非接受者相比，死亡率没有差异(分别为33.3%和21.4%，p=0.47)。然而，在死亡风险较低的30名患者中，只有8名(26.7%)接受了AIG-IV(p=0.01)，而13名死亡风险较高的患者(SOFA为6-11分)中有7名(53.9%)接受了治疗(p=0.78)。总体而言，AIG-IV接受者接受手术的频率更高，幸存者的住院时间更长(均p0.05)。总体而言，在这次疫情中，接受AIG-IV的人比没有接受人的人病情更重。这种差异和少数高危患者，混淆了评估AIG-IVs在暴发中的有效性。

We analyzed the largest clinical experience to date with Anthrax Immune Globulin Intravenous (AIG-IV) from an outbreak of Bacillus anthracis soft tissue infection in injection drug users and compared findings from 15 AIG-IV recipients versus 28 non-recipients. Overall, mortality rates did not differ comparing recipients vs. non-recipients (33.3% vs. 21.4% respectively, p=0.47). However, whereas only 8 of 30 patients (26.7%) with a low risk of death admission sequential organ failure assessment score (SOFA) of 0 to 5 received AIG-IV (p=0.01compared to a proportion of 50%), 7 of the 13 patients (53.9%) with a high risk of death (SOFA of 6 to 11) received treatment (p=0.78). Overall, AIG-IV recipients had surgery more often and, among survivors, longer hospital stays (all p0.05). Overall, AIG-IV recipients were sicker than non-recipients in this outbreak. This difference and the small number of higher risk patients, confound assessment of AIG-IVs effectiveness in the outbreak.