Document Detail


Duration of vancomycin treatment for coagulase-negative Staphylococcus sepsis in very low birth weight infants.
MedLine Citation:
PMID:  23210694     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Vancomycin is widely used to treat late onset coagulase-negative Staphylococcus (CoNS) sepsis in very low birth weight (VLBW) infants. Although vancomycin is associated with a risk of toxicity and bacterial resistance, the appropriate duration of use has not been established. This study sought to investigate the association between the duration of vancomycin therapy and clinical outcome in VLBW infants with CoNS sepsis.
METHODS: The files of all VLBW infants treated for CoNS sepsis at a tertiary paediatric medical centre from 1995-2003 were reviewed for clinical data, laboratory variables and outcome. Only patients with two positive diagnostic blood cultures were included. The findings were analyzed by duration of vancomycin treatment after the last positive blood culture.
RESULTS: The study cohort included 126 infants, 48 treated for 5 days, 32 for 6-7 days, 31 for 8-10 days and 15 for >10 days. There were no differences among the groups in perinatal characteristics, central catheter dwell time, laboratory data including haematologic, renal and liver function tests, or rate of complications of prematurity. Five infants were diagnosed with infective endocarditis or aortic thrombi and were treated for >10 days. CoNS sepsis recurred in two infants (1.6%). No toxicity of vancomycin treatment was observed.
CONCLUSIONS: In VLBW infants with uncomplicated CoNS sepsis, treatment with vancomycin for 5 days after the last positive blood culture appears to be associated with a satisfactory outcome and no adverse effects. A well-controlled prospective multicentre study is needed to confirm these findings.
Authors:
Nehama Linder; Daniel Lubin; Adriana Hernandez; Limor Amit; Shai Ashkenazi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  British journal of clinical pharmacology     Volume:  76     ISSN:  1365-2125     ISO Abbreviation:  Br J Clin Pharmacol     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-06-20     Completed Date:  2014-02-03     Revised Date:  2014-07-01    
Medline Journal Info:
Nlm Unique ID:  7503323     Medline TA:  Br J Clin Pharmacol     Country:  England    
Other Details:
Languages:  eng     Pagination:  58-64     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors. British Journal of Clinical Pharmacology © 2012 The British Pharmacological Society.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / administration & dosage,  therapeutic use*
Bacteremia / drug therapy*,  microbiology
Coagulase / metabolism
Cohort Studies
Drug Administration Schedule
Female
Humans
Infant, Newborn
Infant, Very Low Birth Weight
Male
Retrospective Studies
Staphylococcal Infections / drug therapy*,  microbiology
Staphylococcus / enzymology,  isolation & purification
Time Factors
Treatment Outcome
Vancomycin / administration & dosage,  therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Coagulase; 6Q205EH1VU/Vancomycin
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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