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Postexposure rabies prophylaxis regimen may be promising
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A postexposure rabies prophylaxis regimen involving a series of four-site injections over the course of one week may have more immunogenicity than the frequently-used two-site intradermal regimen, according to results of a recent study.
Participants in one arm of the study received four-site intradermal injections of 0.1 mL of purified Vero cell rabies vaccine to the deltoids and thighs on days zero, three and seven, with or without equine rabies immunoglobulin (40 IU/kg). Participants in the control arm were administered two-site intradermal injections on days zero, three and seven and one injection on days 28 and 90 with equine rabies immunoglobulin.
The regimen administered to the control arm, known as the Thai Red Cross regimen, has been widely used and is approved by WHO.
The researchers measured rabies neutralizing antibody up to day 360.
Participants who received the four-site intradermal regimen, with or without equine rabies immunoglobulin, had significantly higher geometric mean titers of rabies neutralizing antibodies than participants in the control group on days 14 and 28 (P>.001).
Rabies neutralizing antibody values ≥0.5 IU/mL on days 14 and 28 were observed in all participants in all groups. There were no significant differences between the three groups in the percentages of patients who had ≥0.5 IU/mL rabies neutralizing antibody values at days zero through 360.
The weeklong, four-site regimen could be a convenient option for small clinics, the researchers wrote.
Shantavasinkul P et al. Clin Infect Dis. 2009;50:56-60.