Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Immunoglobulin G (IgG), particularly in the form of intravenous immunoglobulin (IVIG), has a scientific basis for use in certain severe or refractory Staphylococcus aureus infections, although it is not a frontline or routine therapy. The rationale for its use is that IVIG contains pooled antibodies from thousands of donors, including antibodies capable of neutralizing various staphylococcal toxins (such as toxic shock syndrome toxin-1 and staphylococcal enterotoxins) and potentially enhancing opsonization of the bacteria for immune clearance.

Clinical evidence supporting IVIG use in staph infections is limited and mostly pertains to toxin-mediated conditions such as toxic shock syndrome (TSS) and severe necrotizing infections, rather than standard skin/soft tissue or systemic staph infections. Some small studies and case reports suggest benefit in these severe scenarios, showing improved outcomes when IVIG is used as adjunctive therapy alongside antibiotics and supportive care. However, large randomized controlled trials are lacking, and the overall quality of evidence is moderate at best.

Major guidelines (such as those from the Infectious Diseases Society of America) suggest considering IVIG in select cases of severe toxin-mediated staphylococcal disease, but not for routine staph infections. Thus, the use of IgG for staph infections is scientifically justified in select severe cases, with a moderate level of supporting evidence, but it is not a standard treatment for all staph infections.

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