[Immunoglobulins in bacterial and viral meningitis. Results of a controlled randomized clinical study of intravenous and intrathecal application].

The efficacy of additional intravenous and intrathecal immunoglobulin (Ig) therapy was investigated in a randomized clinical trial with 68 patients divided with the aid of a list of random numbers into two groups according to their infection. The group of bacterial infections of the CNS included 29 patients and the group of virus infections of the CNS 39 patients. The statistical evaluation of patients with bacterial infections and of those with virus infections was done separately. Group 1 received 10 g Ig each as a short infusion on two consecutive days. Patients with bacterial infections received in addition on every second day and patients with viral infections on every fifth day 500 mg of the same preparation by intrathecal injection. In contrast to this, a control group received the usual therapy only, principally antibiotics for purulent meningitis. The following characteristics were investigated and compared as variable criteria of the course of the disease and consequently of the efficacy of the additional therapy with Ig: CSF cell count, CSF protein, pyrexia, general condition, paralyses, neuropsychological defects, vigilance and EEG recording. As overall criteria of the course of the disease the length of stay in hospital and the rise in temperature were considered. The results of the statistical analysis showed a statistically significant superiority for the Ig-treatment which was most marked in the regression of the CSF pleocytosis, total CSF protein and pyrexia. For the subjectively graded clinical evaluations such as general condition, disturbances of vigilance, transient paralyses, neuropsychological defects and EEG tracings the statistical significance still applied, even if not so pronounced as for the previously mentioned criteria.

RCT Entities:   Population Interventions Outcomes