I am sorry we have never used OK432 in our patients.

However for some patients with cystic hygroma (depending on their localization) and potential risk for neural damage, you can use absolute ethanol or ethanol/air mixture for local sclerotherapy.

Although some authors have reported watchful waiting for cystic hygroma (CH), this should be considered only in patients who are asymptomatic. Medical treatment of CH consists of the administration of sclerosing agents, such as OK-432 (an inactive strain of group A Streptococcus pyogenes), bleomycin, pure ethanol, bleomycin, sodium tetradecyl sulfate, and doxycycline.[10]

An infected CH should be treated with intravenous antibiotics, and definitive surgery should be performed once the infection has resolved. Incision and drainage or aspiration results in only temporary shrinkage, and subsequent fibrosis can further complicate the resection. Radiotherapy has not been demonstrated to be effective. The preferred treatment of all CH is surgical resection. Only resection can truly offer the potential for cure.

OK-432

Although not currently approved by the US Food and Drug Administration (FDA), OK-432 has been reported to successfully treat CH.[11] The mechanism of action is proposed to be an inflammatory response to the inactive bacteria, leading to fibrosis of the hygroma. OK-432 may be a viable option for large unilocular cysts.

Currently, OK-432 is available in the United States only by protocol. It does not work well for small cysts.[12] Because the procedure for using OK-432 involves aspiration prior to injection of the sclerosant, some have hypothesized that the true effect is from the aspiration.

Doxycycline

Doxycycline has been reported as a potential sclerotherapy agent, with both safety and efficacy. Like most other sclerosant agents, it has shown the highest efficacy in macrocystic lesions and the lowest efficacy in microcystic one.

Regards

http://emedicine.medscape.com/article/994055-treatment