Trial reportIntensive care medicine2017
Immunoglobulin G for patients with necrotising soft tissue infection (INSTINCT): a randomised, blinded, placebo-controlled trial.
Trial report in Intensive care medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02111161 (Immunoglobulin for Necrotizing Soft Tissue Infections), which is not on this map. Cited by 55 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Immunoglobulin for Necrotizing Soft Tissue Infections: a Randomised Controlled Trial
Who cites it
55 citing papers in PubMed, 3 syntheses or guidelines pooled it, 123 citations in OpenAlex.
- Outcomes and management of pregnancy and puerperal group A streptococcal infections: A systematic review.Acta obstetricia et gynecologica Scandinavica · 2023Pooled it
- Prognostic factors for streptococcal toxic shock syndrome: systematic review and meta-analysis.BMJ open · 2022Pooled it
- Interventions for necrotizing soft tissue infections in adults.The Cochrane database of systematic reviews · 2018Pooled it
- High-dose intravenous immunoglobulin versus albumin 4% in paediatric toxic shock syndrome: a randomised controlled feasibility study.Archives of disease in childhood · 2024Trial
- Phenotype-based appropriateness of IGM-enriched polyclonal immunoglobulin use in critical illness: report of an expert consensus.Journal of anesthesia, analgesia and critical care · 2026Review
- Electroacupuncture as Adjunctive Therapy for Organ Dysfunction Among Chinese ICU Patients with Sepsis: Study Protocol for a Randomized Clinical Trial.Current medical science · 2026Article
- Clindamycin and intravenous immunoglobulins in pediatric invasive group A streptococcal disease: what is the evidence?European journal of pediatrics · 2026Review
- Host-response trajectories in necrotizing fasciitis: host-pathogen interactions, immune evasion, and immunoparalysis.Frontiers in cellular and infection microbiology · 2026Review
- Revisiting the streptococcal M protein: modern perspectives on antibody function, host interactions, and therapeutic targeting.Frontiers in immunology · 2026Review
- Article
- Top unanswered questions in antimicrobial management of necrotizing soft tissue infections.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Review
- Characteristics, treatments, and outcomes of patients with necrotizing soft tissue infections: a Dutch multicenter cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Serum immunoglobulin G predicts mortality and stratifies intravenous immunoglobulin benefit in sepsis patients.Military Medical Research · 2025Article
- Antibiotic therapy in necrotizing soft tissue infections: a narrative review of the greater Paris SURFAST consortium.Critical care (London, England) · 2025Review
- Article
- Optimizing Antibiotic Choice, Administration, and Duration in NSTI Treatment.Bioengineering (Basel, Switzerland) · 2025Review
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.Journal of intensive care · 2025Article
- Complicated and deep bacterial skin and soft tissue infections.Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG · 2025Review
- The intricate pathogenicity of Group AVirulence · 2024Review
- Treating necrotizing skin and soft-tissue infections.Intensive care medicine · 2024Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of the INSTINCT trial was to assess the effect of intravenous polyspecific immunoglobulin G (IVIG) compared with placebo on self-reported physical function in intensive care unit (ICU) patients with necrotising soft tissue infection (NSTI).
methodsWe randomised 100 patients with NSTI 1:1 to masked infusion of 25 g of IVIG (Privigen, CSL Behring) or an equal volume of 0.9% saline once daily for the first 3 days of ICU admission. The primary outcome was the physical component summary (PCS) score of the 36-item short form health survey (SF-36) 6 months after randomisation; patients who had died were given the lowest possible score (zero).
resultsOf the 100 patients randomised, 87 were included in the intention-to-treat analysis of the PCS score, 42 patients (84%) in the IVIG group and 45 patients (90%) in the placebo group. The two intervention groups had similar baseline characteristics with the exception of IVIG use before randomisation (1 dose was allowed) and rates of acute kidney injury. Median PCS scores were 36 (interquartile range 0-43) in the group assigned to IVIG and 31 (0-47) in the group assigned to placebo (mean adjusted difference 1 (95% confidence interval -7 to 10), p = 0.81). The result was supported by analyses adjusted for baseline prognostics, those in the per protocol populations, in the subgroups (site of NSTI) and those done post hoc adjusted for IVIG use before randomisation.
conclusionsIn ICU patients with NSTI, we observed no apparent effects of adjuvant IVIG on self-reported physical functioning at 6 months.
trial registrationNCT02111161.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.