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最大的临床经验与炭疽免疫球蛋白静脉注射（AIG-IV）从炭疽杆菌软组织感染的爆发注射吸毒者和比较的结果，从15个AIG-IV收件人与28个非收件人。总体而言，接受者与非接受者的死亡率没有差异（分别为33.3%与21.4%，p=0.47）。然而，30例死亡风险较低的患者中仅有8例（26.7%）接受了AIG-IV治疗（SOFA评分为0 - 5）（p= 0.01，比例为50%），而13例死亡风险较高（SOFA评分为6 - 11）的患者中有7例（53.9%）接受了治疗（p=0.78）。总体而言，AIG-IV接受者的手术频率更高，存活者的住院时间更长（所有p <0.05）。总体而言，在这次疫情中，AIG-IV接受者比非接受者病情更重。这种差异和少数高风险患者混淆了对AIG-IV在暴发中有效性的评估。

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.