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Intravenous immunoglobulin (IVIG) utilization in tertiary care hospital

IVIG utilization should be monitored because of increasing IVIG consumption and cost, as well as evidence of inappropriate use and risks to patient.Aim:To evaluate utilization of IVIG in tertiary care hospital and estimate whetherIVIG were used for approved clinical indications.Material and methods:We retrospectively analyzed use of IVIG in Clinical HospitalCenter Zagreb from 1997 to 2002. Medical conditions treated with IVIG were categ-orized into three categories: I-convincing evidence of benefit, II-inconclusive evidenceof benefit and III-no convincing evidence of benefit.Results:Annual use of IVIG increased from 5772 gr in 1997 to 12801 gr in 2002, although number of patients treated with IVIG remained the same (173 patients in 1997vs. 173 patients in 2002). Significantly higher number of neonates were treated withIVIG in 1997 than in 2002 (36% vs. 4%). In 1997 the most common medical conditiontreated with IVIG was sepsis (54%), but in 2002 that were neurological diseases (32%).Although IVIG use for approved medical conditions was higher in 2002 than in 1997(17% vs. 41%), there was still high proportion (39%) of patients treated for medicalconditions without evidence-based benefit of IVIG therapy.Conclusion:The optimum IVIG utilization management require publishing of guide-lines, ongoing physician education about the indications and cost of IVIG and constantmonitoring of use. At least once a year IVIG utilization should be evaluated andcompared with current guidelines.

Intravenous immunoglobulin (IVIG), tertiary care hospital

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