[The use of immunoglobulins in the treatment of infectious diseases]

The use of immunoglobulins in the treatment of infectious diseases has a long tradition. Initially immunoglobulins from hyperimmunised animals were used for their antitoxic and antimicrobial activity. The development of preparations of human intravenous immunoglobulin (IVIG) and the observations of their long-term use enabled to assess their usefulness in the treatment of the diseases of proven or probable infectious etiology. In the treatment of infectious diseases IVIG are currently used as immunomodulating drugs or immunosuppressive therapy, more frequently than the specific antibodies against the viruses, bacteria or their toxins. In practice of the infectious ward IVIG are used as a drug of choice in the treatment of Kawasaki disease, in toxic epidermolysis and Stevens-Johnson syndrome. As adjunctive therapy IVIG are used in the infection with parvovirus B19, in hemophagocytic syndrome, for treatment of infections presenting with a severe toxemia caused by Clostridium difficile, Streptococcus pyogenes and Staphylococcus aureus. The rationale for the use of IVIG may be also serious infections caused by enteroviruses, particularly neuroinfections. The use of IVIG in the treatment of sepsis is controversial, since their effectiveness is not proven.