Intravenous Immunoglobulin (IVIG) in Toxic Shock Syndrome (TSS)

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* 1. Address

Name

Hospital

Address

City/Town

Country

Email Address

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* 2. How many PICU beds are available in your unit?

5-10

11-15

>15

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* 3. Number of admissions per year in your unit:

<400

401-800

>800

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* 4. Nurse/patient ratio in your unit:

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* 5. What is the level of evidence (Oxford EBM classification, see below) for the efficacy of IVIG in TSS?

Level 5

Level 4

Level 3

Level 2

Level 1

1a: Systematic reviews (with homogeneity) of randomized controlled trials
1b: Individual randomized controlled trials (with narrow confidence interval)
1c: All or none randomized controlled trials
2a: Systematic reviews (with homogeneity) of cohort studies
2b: Individual cohort study or low quality randomized controlled trials (e.g. <80% follow-up)
2c: "Outcomes" Research; ecological studies
3a: Systematic review (with homogeneity) of case-control studies
3b: Individual case-control study
4: Case-series (and poor quality cohort and case-control studies)
5: Expert opinion without explicit critical appraisal, or based on physiology, bench research or "first principles"

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* 6. Tick the appropriate statement(s)

IVIG has proven to be effective in adult TSS

IVIG has proven to be effective in adult septic shock

IVIG has proven to be effective in pdiatric TSS

IVIG has proven to be effective in pediatric septic shock

IVIG has proven to be effective in neonatal septic shock

there is no place for IVIG in the treatment of adult TSS

there is no place for IVIG in the treatment of pediatric TSS

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* 7. Do you prescribe IVIG in TSS?

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* 8. If yes, specify the moment:

as soon as the TSS is diagnosed

when the shock is refractory to fluid bolus

when the shock is refractory to vasopressors

when the shock is refractory to inotropes

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* 9. If yes to question 7, specify the total dose used:

0.5 g/kg

1 g/kg

2 g/kg

> 2 g/kg

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* 10. Among the following complications what are those reported with IVIG?

Renal failure

immunoallergy

fluid overload

risk of acquired viral infection

anaphylactic shock

aseptic meningitis

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* 11. According to you, what is the cost of IVIG per gram?

< 20 €/g (23$/g)

20-40 €/g (23-46$/g)

> 40 €/g (46$/g)

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* 12. How many patients with TSS are managed in your PICU each year?

5-10

11-15

> 15

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* 13. In your PICU, what is the estimated percentage of patients treated with IVIG for streptoccoccal TSS

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* 14. In your PICU, What is the estimated percentage of patients treated with IVIG for staphylococcal TSS?

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* 15. Do you prescribe antitoxins antibiotherapy when you face with TSS?

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* 16. If yes, among these antibiotics, which one do you use as antitoxin therapy?

linezolid

telizolid

clindamycine

rifampicine

Other (please specify)

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* 17. Do you use rapid detection test for streptococcus A (streptest or streptatest...) in pleural (or articular) liquid when you face with a child presented with shock, erythrodermia and pleural (or articular) effusion?

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* 18. Would you agree to participate in a randomized controlled trial on the efficacy of IVIG in children with TSS?

yes

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* 1. Address

Question Title

* 2. How many PICU beds are available in your unit?

Question Title

* 3. Number of admissions per year in your unit:

Question Title

* 4. Nurse/patient ratio in your unit:

Question Title

* 5. What is the level of evidence (Oxford EBM classification, see below) for the efficacy of IVIG in TSS?

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* 6. Tick the appropriate statement(s)

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* 7. Do you prescribe IVIG in TSS?

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* 8. If yes, specify the moment:

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* 9. If yes to question 7, specify the total dose used:

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* 10. Among the following complications what are those reported with IVIG?

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* 11. According to you, what is the cost of IVIG per gram?

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* 12. How many patients with TSS are managed in your PICU each year?

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* 13. In your PICU, what is the estimated percentage of patients treated with IVIG for streptoccoccal TSS

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* 14. In your PICU, What is the estimated percentage of patients treated with IVIG for staphylococcal TSS?

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* 15. Do you prescribe antitoxins antibiotherapy when you face with TSS?

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* 16. If yes, among these antibiotics, which one do you use as antitoxin therapy?

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* 17. Do you use rapid detection test for streptococcus A (streptest or streptatest...) in pleural (or articular) liquid when you face with a child presented with shock, erythrodermia and pleural (or articular) effusion?

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* 18. Would you agree to participate in a randomized controlled trial on the efficacy of IVIG in children with TSS?

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* 19. Would you accept to randomize the patient between IVIG and albumine 4 or 5% (double blind)?

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* 20. if yes, do you think that your colleagues would be agree too?