Abstract | BACKGROUND: METHODS: Retrospective study of 137 neonates with CoNS bacteremia during admission to a tertiary NICU between July 2006 and July 2009. Main outcome measures were total duration of bacteremia and the adequacy of vancomycin and rifampin therapy. RESULTS: 137/1696 (8.0%) neonates developed a CoNS bacteremia. Eighteen were treated with rifampin because of persistent bacteremia (3 positive blood cultures at least 48 hours apart with clinical symptoms) or (a serious suspicion of) an intravascular thrombus. Duration of bacteremia prior to rifampin therapy (8.0 ± 3.6 days) was positively correlated (p < 0.001) to the total duration of bacteremia (10.3 ± 3.7 days). After starting rifampin therapy C-reactive protein (CRP) levels of all neonates declined and blood cultures became sterile after 2.3 ± 1.6 days. Vancomycin levels were not consistently measured in all neonates, resulting in late detection of subtherapeutic trough levels. CONCLUSION:
Rifampin may be effective in the treatment of persistent CoNS infections in neonates. Outcome may be improved by adequate monitoring of vancomycin trough levels.
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Authors | N Margreth van der Lugt, Sylke J Steggerda, Frans J Walther |
Journal | BMC pediatrics
(BMC Pediatr)
Vol. 10
Pg. 84
(Nov 19 2010)
ISSN: 1471-2431 [Electronic] England |
PMID | 21092087
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
- Coagulase
- Enzyme Inhibitors
- C-Reactive Protein
- Rifampin
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Topics |
- Bacteremia
(blood, drug therapy, microbiology)
- C-Reactive Protein
(metabolism)
- Coagulase
(analysis)
- Dose-Response Relationship, Drug
- Enzyme Inhibitors
(administration & dosage, therapeutic use)
- Female
- Follow-Up Studies
- Gestational Age
- Humans
- Infant, Newborn
- Intensive Care Units, Neonatal
- Male
- Retrospective Studies
- Rifampin
(administration & dosage, therapeutic use)
- Staphylococcal Infections
(blood, drug therapy, microbiology)
- Staphylococcus
(enzymology, isolation & purification)
- Treatment Outcome
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