Measles Immune globulin (IM) Normal hosts: 0.25 mL/kg IM. Postexposure prophylaxis (within 6 days after exposure) in nonimmune contacts of acute cases.
Immunocompromised hosts: 0.5 mL/kg IM (maximum 15 mL for all patients).
Primary immu-Immune globulin (IV)2 Consult the manufacturer’s dosing nodeficiency recommendations for the specific disorders product being used.
Primary immunodeficiency disorders include specific antibody deficiencies (eg, X-linked agammaglobulinemia) and combined deficiencies (eg, severe combined immunodeficiencies).
Postexposure rabies prophylaxis in persons not previously immunized with rabies vaccine. Must be combined with rabies vaccine.
TABLE A–3 Materials available for passive immunization.1
Respiratory syn-Palivizumab 15 mg/kg IM once prior to the For use in infants and children <24 months with cytial virus (RSV) beginning of the RSV season and once chronic lung disease, hemodynamically significant monthly until the end of the season. congenital heart disease, or a history of premature birth (≥35 weeks of gestation).
Rubella Immune globulin (IM) 0.55 mL/kg IM. Nonimmune pregnant women exposed to rubella who will not consider therapeutic abortion. Administration does not prevent rubella in the fetus of an exposed mother.
Scorpion sting Scorpion Immune 3 vials IV over 10 minutes Use as soon as possible after scorpion sting (Centruroides) F(ab)2
Snake bite Antivenin At least 3–5 vials (30–50 mL) IV initially Neutralizes venom of eastern coral snake and Texas (coral snake) (Micrurus fulvius), within 4 hours after the bite. Additional coral snake. Serum sickness occurs in almost all equine doses may be required. patients who receive >7 vials.
Snake bite Antivenin (Crotalidae) (pit vipers) polyvalent immune Fab, ovine
An initial dose of 4–6 vials should be infused intravenously over 1 hour. The dose should be repeated if initial control is not achieved. After initial control, 2 vials should be given every 6 hours for up to three doses.
Postexposure prophylaxis: 250 units IM. For severe wounds or when there has been a delay in administration, 500 units is recommended.
Treatment: 3000–6000 units IM. Consult the CDC.3
For the management of minimal to moderate North American crotalid envenomation.
Treatment of tetanus and postexposure prophylaxis of nonclean, nonminor wounds in inadequately immunized persons (less than two doses of tetanus toxoid or less than three doses if wound is >24 hours old).
Treatment of severe reactions to vaccinia vaccination, including eczema vaccinatum, vaccinia necrosum, and ocular vaccinia. Available from the CDC.3 1Passive immunotherapy or immunoprophylaxis should always be administered as soon as possible after exposure. Prior to the administration of animal sera, patients should be questioned and tested for hypersensitivity.
2See the following references for an analysis of additional uses of intravenously administered immune globulin: Ratko TA et al: Recommendations for off-label use of intravenously administered immunoglobulin preparations. JAMA 1995;273:1865; and Feasby T et al: Guidelines on the use of intravenous immune globulin for neurologic conditions. Transfus Med Rev 2007;21(2 Suppl 1)S57.