The role of haemopoietic colony-stimulating factors in the management of newborn infection

When neonatal sepsis or necrotising enterocolitis is accompanied by neutropenia, mortality is high. The haemopoietic growth factors rhG-CSF (recombinant human granulocyte-colony stimulating factor) and rhGM-CSF (recombinant human granulocyte macrophage-colony stimulating factor) have been investigated for their ability to enhance neutrophil numbers and function. Evidence to date does not support the routine use of rhG-CSF or rhGM-CSF for either prophylaxis or treatment of newborn sepsis, but use in preterm, neutropenic and septic babies <1500g may be of benefit and could be considered in extreme situations, after consultation with parents.