Postexposure Rabies Prophylaxis Completed in 1 Week: Preliminary Study
Background Patients exposed to a rabid animal often travel long distances to receive postexposure prophylaxis (PEP), which requires 4 or 5 visits. Reducing the number of clinic visits would not only reduce costs for the patient but may also help increase compliance to receive complete PEP. We made a...
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| Veröffentlicht in: | Clinical infectious diseases 2010-01, Vol.50 (1), p.56-60 |
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| creator | Shantavasinkul, Prapimporn Tantawichien, Thanphet Wilde, Henry Sawangvaree, Artikaya Kumchat, Apinya Ruksaket, Natthasri Lohsoonthorn, Vitool Khawplod, Pakamatz Tantawichien, Terapong |
| description | Background Patients exposed to a rabid animal often travel long distances to receive postexposure prophylaxis (PEP), which requires 4 or 5 visits. Reducing the number of clinic visits would not only reduce costs for the patient but may also help increase compliance to receive complete PEP. We made an effort to develop PEP completed in 1 week. Methods We administered the 4-site intradermal injections of 0.1 mL of purified Vero cell rabies vaccine to the deltoids and thighs on days 0, 3, and 7, with and without equine rabies immunoglobulin (40 IU/kg). A control group received the World Health Organization-approved and widely used Thai Red Cross regimen (2-site intradermal injections on days 0, 3, and 7 and 1 injection on days 28 and 90) with equine rabies immunoglobulin. We then determined rabies neutralizing antibody (NAb) up to day 360. Results Geometric mean titers for subjects receiving the 4-site intradermal regimen, with or without equine rabies immunoglobulin, had significantly higher NAb values than did the control group on day 14 and 28 (P |
| doi_str_mv | 10.1086/649211 |
| format | Article |
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Reducing the number of clinic visits would not only reduce costs for the patient but may also help increase compliance to receive complete PEP. We made an effort to develop PEP completed in 1 week. Methods We administered the 4-site intradermal injections of 0.1 mL of purified Vero cell rabies vaccine to the deltoids and thighs on days 0, 3, and 7, with and without equine rabies immunoglobulin (40 IU/kg). A control group received the World Health Organization-approved and widely used Thai Red Cross regimen (2-site intradermal injections on days 0, 3, and 7 and 1 injection on days 28 and 90) with equine rabies immunoglobulin. We then determined rabies neutralizing antibody (NAb) up to day 360. Results Geometric mean titers for subjects receiving the 4-site intradermal regimen, with or without equine rabies immunoglobulin, had significantly higher NAb values than did the control group on day 14 and 28 (P <.001). All subjects in all groups had a NAb value ⩾0.5 IU/mL on days 14 and 28. The percentages of subjects who had a NAb value ⩾0.5 IU/mL from days 0 through 360 were not significantly different among the 3 groups. Conclusions After any PEP regimen, World Health Organization recommendations require a NAb value ⩾0.5 IU/mL on days 14 and 28. The 1-week PEP regimen, therefore, appears promising. It increased immunogenicity over the 2-site intradermal schedule, and it is convenient and can be used in small clinics, because it consumes almost the entire supplied vaccine ampoule volume.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/649211</identifier><identifier>PMID: 19995217</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Oxford: The University of Chicago Press</publisher><subject>Adult ; Analysis of Variance ; Animals ; Antibodies ; Antibodies, Neutralizing - blood ; Antibodies, Viral - blood ; ARTICLES AND COMMENTARIES ; Biological and medical sciences ; Cercopithecus aethiops ; Clinical medicine ; Disease prevention ; Female ; Geometric mean ; Horses ; Human viral diseases ; Humans ; Immune system ; Immunization, Passive - methods ; Immunoglobulins ; Immunoglobulins - administration & dosage ; Infectious diseases ; Injections, Intradermal ; Male ; Medical research ; Medical sciences ; Middle Aged ; Neutralizing antibodies ; Nonprofit organizations ; Post exposure prophylaxis ; Post-Exposure Prophylaxis - methods ; Prospective Studies ; Rabies ; Rabies - immunology ; Rabies - prevention & control ; Rabies vaccines ; Rabies Vaccines - administration & dosage ; Rabies Vaccines - adverse effects ; Rabies Vaccines - immunology ; Vaccination ; Vaccines ; Vero Cells ; Viral diseases ; Viral diseases of the nervous system</subject><ispartof>Clinical infectious diseases, 2010-01, Vol.50 (1), p.56-60</ispartof><rights>2009 Infectious Diseases Society of America</rights><rights>2010 by the Infectious Diseases Society of America 2010</rights><rights>2015 INIST-CNRS</rights><rights>Copyright University of Chicago, acting through its Press Jan 1, 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c453t-a5b28a7825d9f6dcc235be0da2a5f5219a495f65b01dff59cf794fd989b4f9ca3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/27799506$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/27799506$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,4010,27902,27903,27904,57995,58228</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22337852$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19995217$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shantavasinkul, Prapimporn</creatorcontrib><creatorcontrib>Tantawichien, Thanphet</creatorcontrib><creatorcontrib>Wilde, Henry</creatorcontrib><creatorcontrib>Sawangvaree, Artikaya</creatorcontrib><creatorcontrib>Kumchat, Apinya</creatorcontrib><creatorcontrib>Ruksaket, Natthasri</creatorcontrib><creatorcontrib>Lohsoonthorn, Vitool</creatorcontrib><creatorcontrib>Khawplod, Pakamatz</creatorcontrib><creatorcontrib>Tantawichien, Terapong</creatorcontrib><title>Postexposure Rabies Prophylaxis Completed in 1 Week: Preliminary Study</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><addtitle>Clinical Infectious Diseases</addtitle><description>Background Patients exposed to a rabid animal often travel long distances to receive postexposure prophylaxis (PEP), which requires 4 or 5 visits. Reducing the number of clinic visits would not only reduce costs for the patient but may also help increase compliance to receive complete PEP. We made an effort to develop PEP completed in 1 week. Methods We administered the 4-site intradermal injections of 0.1 mL of purified Vero cell rabies vaccine to the deltoids and thighs on days 0, 3, and 7, with and without equine rabies immunoglobulin (40 IU/kg). A control group received the World Health Organization-approved and widely used Thai Red Cross regimen (2-site intradermal injections on days 0, 3, and 7 and 1 injection on days 28 and 90) with equine rabies immunoglobulin. We then determined rabies neutralizing antibody (NAb) up to day 360. Results Geometric mean titers for subjects receiving the 4-site intradermal regimen, with or without equine rabies immunoglobulin, had significantly higher NAb values than did the control group on day 14 and 28 (P <.001). All subjects in all groups had a NAb value ⩾0.5 IU/mL on days 14 and 28. The percentages of subjects who had a NAb value ⩾0.5 IU/mL from days 0 through 360 were not significantly different among the 3 groups. Conclusions After any PEP regimen, World Health Organization recommendations require a NAb value ⩾0.5 IU/mL on days 14 and 28. The 1-week PEP regimen, therefore, appears promising. It increased immunogenicity over the 2-site intradermal schedule, and it is convenient and can be used in small clinics, because it consumes almost the entire supplied vaccine ampoule volume.</description><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Animals</subject><subject>Antibodies</subject><subject>Antibodies, Neutralizing - blood</subject><subject>Antibodies, Viral - blood</subject><subject>ARTICLES AND COMMENTARIES</subject><subject>Biological and medical sciences</subject><subject>Cercopithecus aethiops</subject><subject>Clinical medicine</subject><subject>Disease prevention</subject><subject>Female</subject><subject>Geometric mean</subject><subject>Horses</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immune system</subject><subject>Immunization, Passive - methods</subject><subject>Immunoglobulins</subject><subject>Immunoglobulins - administration & dosage</subject><subject>Infectious diseases</subject><subject>Injections, Intradermal</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neutralizing antibodies</subject><subject>Nonprofit organizations</subject><subject>Post exposure prophylaxis</subject><subject>Post-Exposure Prophylaxis - methods</subject><subject>Prospective Studies</subject><subject>Rabies</subject><subject>Rabies - immunology</subject><subject>Rabies - prevention & control</subject><subject>Rabies vaccines</subject><subject>Rabies Vaccines - administration & dosage</subject><subject>Rabies Vaccines - adverse effects</subject><subject>Rabies Vaccines - immunology</subject><subject>Vaccination</subject><subject>Vaccines</subject><subject>Vero Cells</subject><subject>Viral diseases</subject><subject>Viral diseases of the nervous system</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0dtr1TAYAPAiiptT_wOlCupTNbcvF9_04JwycHjBsZeQpgnmrG1q0sLOf29GDxsI4lMC34_vWlWPMXqNkeRvOFME4zvVIQYqGg4K3y1_BLJhksqD6kHOW4QwlgjuVwdYKQUEi8Pq-Czm2V1NMS_J1V9NG1yuz1Kcfu16cxVyvYnD1LvZdXUYa1z_dO7ybQGuD0MYTdrV3-al2z2s7nnTZ_do_x5VP44_fN-cNKdfPn7avDttLAM6NwZaIo2QBDrleWctodA61BliwJeGlGEKPIcW4c57UNYLxXynpGqZV9bQo-rVmndK8ffi8qyHkK3rezO6uGQtgAHDjML_JaVcSoppkc__ktu4pLGMoUtHiiOFVUEvV2RTzDk5r6cUhjK_xkhfX0CvFyjw6T7b0g6uu2X7lRfwYg9Mtqb3yYw25BtHCKVCAinu2eriMv272JPVbPMc020OIUoxxEu8WePh-sg3cZMuNRdUgD45v9AYPr_fiItzregfA8euTA</recordid><startdate>20100101</startdate><enddate>20100101</enddate><creator>Shantavasinkul, Prapimporn</creator><creator>Tantawichien, Thanphet</creator><creator>Wilde, Henry</creator><creator>Sawangvaree, Artikaya</creator><creator>Kumchat, Apinya</creator><creator>Ruksaket, Natthasri</creator><creator>Lohsoonthorn, Vitool</creator><creator>Khawplod, Pakamatz</creator><creator>Tantawichien, Terapong</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20100101</creationdate><title>Postexposure Rabies Prophylaxis Completed in 1 Week: Preliminary Study</title><author>Shantavasinkul, Prapimporn ; Tantawichien, Thanphet ; Wilde, Henry ; Sawangvaree, Artikaya ; Kumchat, Apinya ; Ruksaket, Natthasri ; Lohsoonthorn, Vitool ; Khawplod, Pakamatz ; Tantawichien, Terapong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c453t-a5b28a7825d9f6dcc235be0da2a5f5219a495f65b01dff59cf794fd989b4f9ca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Analysis of Variance</topic><topic>Animals</topic><topic>Antibodies</topic><topic>Antibodies, Neutralizing - blood</topic><topic>Antibodies, Viral - blood</topic><topic>ARTICLES AND COMMENTARIES</topic><topic>Biological and medical sciences</topic><topic>Cercopithecus aethiops</topic><topic>Clinical medicine</topic><topic>Disease prevention</topic><topic>Female</topic><topic>Geometric mean</topic><topic>Horses</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immune system</topic><topic>Immunization, Passive - methods</topic><topic>Immunoglobulins</topic><topic>Immunoglobulins - administration & dosage</topic><topic>Infectious diseases</topic><topic>Injections, Intradermal</topic><topic>Male</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neutralizing antibodies</topic><topic>Nonprofit organizations</topic><topic>Post exposure prophylaxis</topic><topic>Post-Exposure Prophylaxis - methods</topic><topic>Prospective Studies</topic><topic>Rabies</topic><topic>Rabies - immunology</topic><topic>Rabies - prevention & control</topic><topic>Rabies vaccines</topic><topic>Rabies Vaccines - administration & dosage</topic><topic>Rabies Vaccines - adverse effects</topic><topic>Rabies Vaccines - immunology</topic><topic>Vaccination</topic><topic>Vaccines</topic><topic>Vero Cells</topic><topic>Viral diseases</topic><topic>Viral diseases of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shantavasinkul, Prapimporn</creatorcontrib><creatorcontrib>Tantawichien, Thanphet</creatorcontrib><creatorcontrib>Wilde, Henry</creatorcontrib><creatorcontrib>Sawangvaree, Artikaya</creatorcontrib><creatorcontrib>Kumchat, Apinya</creatorcontrib><creatorcontrib>Ruksaket, Natthasri</creatorcontrib><creatorcontrib>Lohsoonthorn, Vitool</creatorcontrib><creatorcontrib>Khawplod, Pakamatz</creatorcontrib><creatorcontrib>Tantawichien, Terapong</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shantavasinkul, Prapimporn</au><au>Tantawichien, Thanphet</au><au>Wilde, Henry</au><au>Sawangvaree, Artikaya</au><au>Kumchat, Apinya</au><au>Ruksaket, Natthasri</au><au>Lohsoonthorn, Vitool</au><au>Khawplod, Pakamatz</au><au>Tantawichien, Terapong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Postexposure Rabies Prophylaxis Completed in 1 Week: Preliminary Study</atitle><jtitle>Clinical infectious diseases</jtitle><stitle>Clinical Infectious Diseases</stitle><addtitle>Clinical Infectious Diseases</addtitle><date>2010-01-01</date><risdate>2010</risdate><volume>50</volume><issue>1</issue><spage>56</spage><epage>60</epage><pages>56-60</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>Background Patients exposed to a rabid animal often travel long distances to receive postexposure prophylaxis (PEP), which requires 4 or 5 visits. Reducing the number of clinic visits would not only reduce costs for the patient but may also help increase compliance to receive complete PEP. We made an effort to develop PEP completed in 1 week. Methods We administered the 4-site intradermal injections of 0.1 mL of purified Vero cell rabies vaccine to the deltoids and thighs on days 0, 3, and 7, with and without equine rabies immunoglobulin (40 IU/kg). A control group received the World Health Organization-approved and widely used Thai Red Cross regimen (2-site intradermal injections on days 0, 3, and 7 and 1 injection on days 28 and 90) with equine rabies immunoglobulin. We then determined rabies neutralizing antibody (NAb) up to day 360. Results Geometric mean titers for subjects receiving the 4-site intradermal regimen, with or without equine rabies immunoglobulin, had significantly higher NAb values than did the control group on day 14 and 28 (P <.001). All subjects in all groups had a NAb value ⩾0.5 IU/mL on days 14 and 28. The percentages of subjects who had a NAb value ⩾0.5 IU/mL from days 0 through 360 were not significantly different among the 3 groups. Conclusions After any PEP regimen, World Health Organization recommendations require a NAb value ⩾0.5 IU/mL on days 14 and 28. The 1-week PEP regimen, therefore, appears promising. It increased immunogenicity over the 2-site intradermal schedule, and it is convenient and can be used in small clinics, because it consumes almost the entire supplied vaccine ampoule volume.</abstract><cop>Oxford</cop><pub>The University of Chicago Press</pub><pmid>19995217</pmid><doi>10.1086/649211</doi><tpages>5</tpages></addata></record> |
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| source | Jstor Complete Legacy; Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Analysis of Variance Animals Antibodies Antibodies, Neutralizing - blood Antibodies, Viral - blood ARTICLES AND COMMENTARIES Biological and medical sciences Cercopithecus aethiops Clinical medicine Disease prevention Female Geometric mean Horses Human viral diseases Humans Immune system Immunization, Passive - methods Immunoglobulins Immunoglobulins - administration & dosage Infectious diseases Injections, Intradermal Male Medical research Medical sciences Middle Aged Neutralizing antibodies Nonprofit organizations Post exposure prophylaxis Post-Exposure Prophylaxis - methods Prospective Studies Rabies Rabies - immunology Rabies - prevention & control Rabies vaccines Rabies Vaccines - administration & dosage Rabies Vaccines - adverse effects Rabies Vaccines - immunology Vaccination Vaccines Vero Cells Viral diseases Viral diseases of the nervous system |
| title | Postexposure Rabies Prophylaxis Completed in 1 Week: Preliminary Study |
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