Masters Degrees (Paediatrics and Child Health)

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Browsing Masters Degrees (Paediatrics and Child Health) by Subject "BCG immunotherapy"

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    The outcome of accidental BCG overdosing during routine immunization of neonates
    (Stellenbosch : Stellenbosch University, 2019-12) Greybe, Leonore; Morrison, Julie; Cotton, Mark F.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health.
    ENGLISH ABSTRACT: In January 2015, 19 neonates were accidently given intradermal BCG culture SSI, a dose 62.5 times above the standard BCG dose for neonates at a Western Cape private hospital. After recognizing the error, all neonates who were given BCG culture instead of the BCG vaccine were identified and their parents informed. A panel of paediatric infectious disease specialists were consulted and the decision was made to start treatment with high dose isoniazid and rifampicin. Fourteen of the nineteen neonates were enrolled and followed-up in order to observe what proportion of neonates would develop adverse reactions. Complications that were observed for included severe local and regional adverse reactions and systemic BCG disease. In this case series, no regional or systemic BCG disease occurred in any of the healthy term neonates who received an accidental overdose of BCG culture, instead of BCG vaccine. The conclusions of this case series are however limited by inconsistent follow-up and failure by the treating paediatricians to systematically record the required data. Expected mild adverse reactions occurred in all the neonates (n=14, 100%) in our study, which was much higher than expected when compared to the usual occurrence of BCG adverse reactions to the Bacillus Calmette-Guerin (BCG) vaccine in neonates as demonstrated by the randomised control trial by Nissen et al. The more common occurrence of mild adverse reactions could be explained by the much higher dose of BCG administered. The majority of local adverse reactions were however of short duration with approximately one third resolving within 2 weeks and not a single one being present at 6 months.