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The Availability of Specific Pneumococcus Antibody after Intravenous, Intramuscular, and Subcutaneous Injection¹

Including a Study of the Cutaneous Reactions to Type-Specific Polysaccharides Following Serum Injection

From the Thorndike Memorial Laboratory, Second and Fourth Medical Services (Harvard), Boston City Hospital and the Department of Medicine, Harvard Medical School, Boston, Mass.

Abstract

1. The intravenous route is the method of choice for the administration of concentrated antipneumococcic antibody, since by this route a greater concentration of antibody is attained more constantly, appears more rapidly, and persists longer than when given by the intramuscular or subcutaneous routes.

2. While an occasional individual may, after an intramuscular injection, attain a concentration of circulating antibody similar to that usually observed following the intravenous administration of the same amount of antibody, most subjects injected intramuscularly or subcutaneously acquire only one per cent or less of the concentration of circulating antibody observed after the same amount is injected intravenously.

3. Individual subjects vary considerably in the titer of circulating antibody attained and in the maintenance of this titer after administration of antibody under apparently similar conditions.

4. There may be some variation in absorption dependent on the lot of serum used, apart from its content in units of antibody.

5. Positive immediate cutaneous reactions to type-specific pneumococcic polysaccharides may be elicited after the administration of the homologous type antipneumococcic horse-serum by any parenteral route. There is considerable individual variation with respect to the occurrence of these reactions and the interval after injection when they can be first elicited.

6. In patients with pneumonia, untoward reactions to initial injections of concentrated antibody are considerably less frequent after intramuscular injection than after intravenous injections of the same or even smaller doses. An initial intramuscular injection may reduce the incidence of chills after subsequent intravenous injections.

Footnotes

¹ This study was aided, in part, by a grant given in honor of Francis Weld Peabody by the Ella Sachs Plotz Foundation.

² This work was carried out with the technical assistance of Mrs. Mildred W. Barnes.