Document Detail

A seven-year survey of management of coagulase-negative staphylococcal sepsis in the neonatal intensive care unit: vancomycin may not be necessary as empiric therapy.
MedLine Citation:
PMID:  21455008     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The typical empiric therapy for coagulase-negative staphylococcal (CONS) sepsis includes vancomycin. In our neonatal intensive care unit, we have consistently avoided the use of vancomycin to treat CONS sepsis, except for specific cases, and have used instead cefazolin as empiric agent.
OBJECTIVES: The clinical outcome of infants with CONS sepsis was evaluated in relation to the susceptibility of CONS blood isolates to cefazolin over a period of 7 years.
METHODS: Clinical characteristics, symptoms of sepsis and antibiotic use were studied retrospectively. Susceptibility of CONS blood isolates to cefazolin was determined by E-test.
RESULTS: Of 163 infants with proven CONS sepsis, 121/140 (86%) infants with a cefazolin-susceptible (minimum inhibition concentration (MIC) ≤8 mg/l) and 21/23 (91%) with a cefazolin-resistant (MIC ≥32 mg/l) blood isolate were treated with cefazolin. 21 (13%) infants were switched to vancomycin, in only 3 of them CONS had become resistant to cefazolin. The majority (81%) of the infants with a good response to cefazolin had the indwelling central venous catheter removed, in contrast to only 22% of the infants with cefazolin treatment failure. Median cefazolin MIC values were 0.75-2 mg/l during the study period.
CONCLUSIONS: The great majority of infants with CONS sepsis was successfully treated with cefazolin. The use of vancomycin could be restricted to specific cases. Despite the consistent use of cefazolin in neonatal CONS sepsis over an extended period of time, cefazolin MIC values remained low and in the susceptible range. Removal of the central venous catheter in infants with clinical symptoms of sepsis is an important therapeutic measure.
Marieke A C Hemels; Agnes van den Hoogen; Malgorzata A Verboon-Maciolek; André Fleer; Tannette G Krediet
Related Documents :
3763068 - Perinatal listeriosis (early-onset): correlation of antenatal manifestations and neonat...
21078608 - Global fibrinolytic capacity in neonatal sepsis.
17413868 - Effect of late-onset sepsis on energy expenditure in extremely premature infants.
10796138 - Intrapartum antibiotics for group b streptococcal colonisation.
15912468 - Qualitative venous doppler flow waveform analysis in preterm intrauterine growth-restri...
8555718 - Two longitudinal studies of the abilities of people with down's syndrome.
Publication Detail:
Type:  Journal Article     Date:  2011-04-01
Journal Detail:
Title:  Neonatology     Volume:  100     ISSN:  1661-7819     ISO Abbreviation:  Neonatology     Publication Date:  2011  
Date Detail:
Created Date:  2011-08-11     Completed Date:  2012-01-26     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  180-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 S. Karger AG, Basel.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Anti-Bacterial Agents / therapeutic use
Cefazolin / therapeutic use
Coagulase / metabolism
Infant, Newborn*
Intensive Care Units, Neonatal*
Longitudinal Studies
Retrospective Studies
Sepsis / drug therapy*
Staphylococcal Infections / drug therapy*
Staphylococcus / metabolism
Treatment Outcome
Vancomycin / therapeutic use*
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Coagulase; 6Q205EH1VU/Vancomycin; IHS69L0Y4T/Cefazolin

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

Previous Document:  Randomized controlled trial: impact of glycerin suppositories on time to full feeds in preterm infan...
Next Document:  Are Gentamicin and/or Vancomycin Associated with Ototoxicity in the Neonate? A Retrospective Audit.