Immunoglobulins in neonatal sepsis: has the final word been said?

Systemic infection is a major cause of mortality and morbidity among premature neonates. In this fragile population, the immaturity of the innate immune response relates inversely to gestational age and is one of the determinants of susceptibility to infections. Antibiotic therapy, even when appropriately and timely instituted, may fail to prevent death or significant sequelae. The quest for additional strategies is still open; in this scenario, the supplementation with exogenous immunoglobulins represents an attractive additional strategy of defence. As current data are conflicting, we provide a critical appraisal with a focus on IgM enriched immunoglobulins preparations.