The UK Department of Health recommends that infants be immunised against Haemophilus influenzae (HIb) at 2, 3 and 4 months of age regardless of gestation. Dexamethasone (Dex), commonly used in the management of chronic lung disease may affect the immune response in these infants.
Unselected cohort of 59 infants of less than 32 weeks gestation or 1500g birthweight. 43 infants received Dex.
Infants received HIb immunisation at 2, 3 and 4 months postnatal age. Bloods obtained pre 1st dose and 2 months after 3rd dose. HIb antibodies measured using HbO-HA with monoclonal pan IgG conjugates and differences in Geometric Mean Titres analysed.
The use of Dex was associated with a significant diminution in titres. GMT 0.5125 vs 4.6311 (p=0.031). The final antibody level in 56% of infants receiving Dex did not achieve a protective titre of 1.0μg/ml. There was a small though significant correlation between Dex dose and GMT (p=0.014).
Dexamethasone appears to have a significant effect on the response of preterm infants to HIb.
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M J Robinson1 (Intr. M A Thomson)
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Robinson, M., Powell, P., Sims, D. et al. Antibody Response to Accelerated HIb Immunisation in Preterm Infants Receiving Dexamethasone During the Management of Chronic Lung Disease. Pediatr Res 42, 385 (1997). https://doi.org/10.1203/00006450-199709000-00024
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DOI: https://doi.org/10.1203/00006450-199709000-00024
