***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background : Bacterial sepsis is one of the major causes of mortality in newborn infants . Mortality increases when sepsis is associated with neutropenia . Material s and Methods : We conducted a prospect i ve , r and omized , double-blind , placebo-controlled trial of recombinant human granulocyte colony-stimulating factor on preterm neonates ( gestational age ( GA ) < 34 weeks ) with sepsis and absolute neutrophil count ( ANC ) of < 1500 cells/mm3 .  Mortality , duration of Neonatal Intensive Care Unit ( NICU ) stay , hematological parameters ( ANC , platelet count , and total leukocyte count ) were compared between the two groups . The  GCSF group ( n=39 ) received GCSF intravenously in a single daily dose of 10 μg/kg/day in a 5 % dextrose solution over 20 - 40 min for three consecutive days , while the control  group ( n=39 )  received placebo of an equivalent volume of 5 % dextrose . Results : Baseline demographic profile among the two groups was comparable . Mortality rate  in the GCSF group was significantly lower than in the control group ( 10 % vs. 35 % ; P<0.05 ) . By day 3 of treatment , ANC in the GCSF group was significantly higher ( 3521±327 ) compared to 2094±460 in the control group , with P value being < 0.05 . Duration of NICU stay also decreased significantly in the GCSF group . Conclusion : The administration of GCSF in preterms with septicemia and neutropenia result ed in lower mortality rates . Further studies are required to confirm our results and establish this adjunctive therapy in neonatal sepsis Neonates are susceptible to septicemia secondary to quantitative and qualitative neutrophilic defects . Granulocyte colony-stimulating factor ( G-CSF ) stimulates myeloid progenitor cell proliferation and induces selective neutrophil functions . The authors aim ed to evaluate the effect of G-CSF administration in septic neonates on neutrophil production and CD11b expression . Sixty septic neonates were r and omized to receive intravenous G-CSF 10 μg/kg/day for 3 days ( G-CSF group , n = 30 ) , or not to receive G-CSF ( non – G-CSF group , n = 30 ) . Thirty healthy newborns were included as controls . Laboratory investigations included complete blood count , C-reactive protein , blood culture , renal and liver function tests , and assessment of neutrophilic expression of CD11b . Total leukocytes count ( TLC ) , absolute neutrophil count ( ANC ) , and immature myeloid cell count in G-CSF group showed significant difference between post– and pre – G-CSF levels . TLC , ANC , immature myeloid cell count and immature/total myeloid cells ratio were higher in G-CSF group compared to non – G-CSF group on days 1 and 3 . Higher neutrophilic expression of CD11b was reported in both septic groups on day 0 compared to control group . On day 5 , CD11b was  higher in G-CSF group than non – G-CSF group . G-CSF improved CD11b% in neutropenic and non-neutropenic septic neonates . No significant difference was found between pre- and posttreatment renal and liver function tests . Lower duration of antibiotic intake and hospitalization was observed in G-CSF group compared to non – G-CSF group . G-CSF administration as an adjuvant therapy for neonatal septicemia , whether neutropenic or not , improves neutrophilic count and function and contributed to early healing from sepsis BACKGROUND To investigate the efficacy and safety of recombinant human granulocyte colony-stimulating factor , recombinant human granulocyte-macrophage colony-stimulating factor ( rhG-CSF ) to treat sepsis in neutropenic preterm infants . METHODS Fifty-six neutropenic preterm infants with suspected or culture-proven sepsis hospitalized in Zeynep Kamil Maternity and Children 's Educational and Training Hospital , Kozyatağı/Istanbul , Turkey between January 2008 and January 2010 were enrolled . Patients were r and omized either to receive rhG-CSF plus empirical antibiotics ( Group I ) or empirical antibiotics alone ( Group II ) . Clinical features were recorded . Daily complete blood count was performed until neutropenia subsided . Data were analyzed using SPSS version 11.5 . RESULTS Thirty-three infants received rhG-CSF plus antibiotic treatment and 23 infants received antibiotic treatment . No drug-related adverse event was recorded . Absolute neutrophil count values were significantly higher on the 2(nd ) study day and 3(rd ) study day in Group I. Short-term mortality did not differ between the groups . CONCLUSION Treatment with rhG-CSF result ed in a more rapid recovery of ANC in neutropenic preterm infants . However , no reduction in short-term mortality was documented In a prospect i ve double‐blind study , st and ard intravenous immunoglobulin ( IVIG ) was compared with an IgM‐enriched IVIG in the treatment of neonatal sepsis . The two treatment groups were also compared with matched controls . One hundred and thirty babies ( 65 in each group ) ranging from 0 to 24 days old , 480 to 4200 g in weight and born between 24 and 42 weeks of gestation who had , or were suspected of having , sepsis were given either st and ard IVIG or IgM‐enriched IVIG ( 250 mg/kg per day ) for 4 days in addition to supportive and antibiotic therapy . A further 65 babies who received similar supportive , antibiotic and fluids but not IVIG were used as matched  controls . Mortality from infection in ‘ culture proven sepsis ’ was 3/44 ( 6·8 % ) in the IgM‐enriched IVIG group , 6/42 ( 14·2 % ) in the st and ard IVIG group , and 11/43 ( 25·5 % ) in the control group ( P = 0·017 , IgM versus control , P = 019 st and ard IVIG versus control ) . There was no statistical difference in the outcome between the two immunoglobulin therapy groups ( P = 0·25 ) . The study indicates that IVIG improves outcome in neonatal sepsis when used as an adjunct to supportive and antibiotic therapy , but larger studies are required to confirm this OBJECTIVES The primary objective was to investigate the safety of recombinant human granulocyte colony stimulating factor ( rhG-CSF ) for the treatment of very low birthweight infants ( VLBW ) with sepsis and relative neutropenia , specifically with regard to worsening of respiratory distress and thrombocytopenia and all cause mortality . Secondary objectives were to evaluate duration of ventilation , intensive care , and antibiotic use as markers of efficacy . DESIGN Neonates ( ⩽ 28 days ) in intensive care , with birth weights of 500–1500 g , absolute neutrophil count ( ANC ) of ⩽ 5 × 109/l , and clinical evidence of sepsis , were r and omly assigned to receive either rhG-CSF ( 10 μg/kg/day ) administered intravenously ( n = 13 ) , or placebo ( n = 15 ) for a maximum of 14 days , in addition to st and ard treatment and antibiotics . All adverse events , oxygenation index , incidence of thrombocytopenia , all cause mortality , duration of ventilation , intensive care and antibiotic treatment , and ANC recovery were compared between the two groups . RESULTS Adverse events and oxygenation index were not increased by , and thrombocytopenia was not attributable to , treatment with rhG-CSF . At 6 and 12 months postmenstrual age , there were significantly fewer deaths in the group receiving rhG-CSF ( 1/13 v 7/15 ; p ⩽ 0.038 ) . There was a non-significant trend towards a reduction in duration of ventilation , intensive care , and antibiotic use in the rhG-CSF group . There was a significantly more rapid increase in ANC in the rhG-CSF treated babies ( p < 0.001 ) . CONCLUSIONS In a small r and omised placebo controlled trial in a highly selected group of neonates , adjuvant treatment with rhG-CSF increased ANC rapidly , and no treatment related adverse events were identified . Mortality at 6 and 12 months postmenstrual age was significantly lower in the treatment group . A large trial investigating efficacy in a similar group of neonates is warranted . Key messages rhG-CSF increases the absolute neutrophil count in very low birthweight infants with neutropenia and sepsis Thrombocytopenia is not an effect of rhG-CSF treatment Potential beneficial effects on long term survival require further In a double blind controlled study antilipopolysaccharide gammaglobulin given intramuscularly did not reduce mortality in low birthweight babies suffering from septicaemia . It did , however , reduce the recovery period of survivors from 310 to 120 hours Thirty-seven neonates with confirmed septicemia through hemoculture were studied . Of them , 18 were treated with antibiotic and the other 19 were given 500 mg/kg of intravenous immunoglobin with a pH of 4.25 ( IGIV ) . The greater part of the neonates in this study were full-term or near full-term . There were no differences in age , gestational age and weight , nor in mortality , the bacterias found and the clinical manifestations which were seen in both groups . Yet , the hospitalary stay was shorter for those in the group treated with IGIV ( 13.9 + /- 5.7 days ) than in the trial group ( 24.4 + /- 10.3 days ) ; as well as some clinical manifestations like diarrhea and splenomegalia ( P < 0.05 ) . The serum of the neonates from the IGIV group showed a greater capacity of opsonization and inhibition of bacterial growth than those in the trial group ( P < 0.001 ) , coinciding with an increase of 300 mg/dL in the serum levels of IgG of the group treated with IGIV from the 3rd day of the study and the C4 and B-Properdine factor serum levels from the 7th day of the study , while in the trial group , there were no changes in these factors ( P < 0.001 ) . Even though no differences were seen in the mortality rate due to septicemia , the results suggest a much shorter evolution of the illness in patients treated with IGIV  . In addition , the serum of those patients treated with IGIV showed in in vitro studies , a better bacteriostatic activity and a better capacity to opsonize the bacterias isolated in the hemocultures . ( ABSTRACT TRUNCATED AT 250 WORDS Objective . Preterm neonates undergoing intensive care have high morbidity from sepsis . These infants also frequently develop neutropenia , and when this is associated with sepsis , mortality is high . This study investigates the potential for granulocyte-macrophage colony-stimulating factor ( GM-CSF ) to effect a clinical ly relevant increase in neutrophil number when used prophylactically in high-risk preterm neonates , and assesses its safety in this population . Design . In an open , r and omized , controlled study , 75 neonates ( 25 small for gestational age ) < 32 weeks gestation were r and omized to receive GM-CSF ( 10 μg/kg/d ) by subcutaneous injection for 5 days from < 72 hours after birth , or to a control group . The primary outcome measure was the neutrophil count during 14 days from study entry . The infants were monitored for potential toxicity . Clinical outcomes , sepsis , and mortality , were recorded , but this initial study was not design ed to address clinical benefit . Results . Prophylactic GM-CSF therapy completely abolished neutropenia in treated infants , when both well and septic , throughout the period of study . Neutropenia ( ≤1.7 × 109/L ) developed in 16 of 39 control infants . Five control infants experienced an acute decrease in neutrophil count coincident with the onset of sepsis . There was no evidence of hematologic , respiratory , or gastrointestinal toxicity in treated infants . Treated infants had a trend to fewer symptomatic , blood culture positive septic episodes than controls during 2 weeks from study entry ( 11/36 vs 18/39 ) . Conclusion . Five-day prophylactic GM-CSF completely abolishes postnatal neutropenia and sepsis-induced neutropenia in preterm neonates at high risk of sepsis , and so removes an important risk factor for sepsis and sepsis-related mortality . GM-CSF , preterm neonates , neutropenia , sepsis Abstract The objective of this study was to investigate the effect of treatment with recombinant human granulocyte-colony stimulating factor ( rhG-CSF ) on the neutrophil count and function of preterm neonates with documented sepsis . For this purpose 62 preterm neonates with proven sepsis and 19 healthy preterm ones were studied . Of the 62 patients , 27 septic neonates had an absolute neutrophil count ( ANC ) > 5000/mm3 ( group A ) and were scheduled not to receive rhG-CSF and 35/62 
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Conclusions No significant differences in all-cause mortality or the duration of hospital stay were found in neonates with suspected or proven sepsis treated with the four types of immunotherapies and those treated with placebo