Vancomycin for prophylaxis against sepsis in preterm neonates

Craft, Alissa; Finer, Neil N.; Barrington, Keith J.

doi:10.1002/14651858.cd001971

Cited by 47 publications

(28 citation statements)

References 22 publications

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“…Though prophylactic antibiotics by and large have no role in the prevention of sepsis, a recent review of studies using low-dose vancomycin as a continuous infusion in ELBW neonates on hyperalimentation has shown that it reduces the incidence of both total neonatal nosocomial sepsis and coagulase negative staphylococcal sepsis. However, there is insufficient evidence to ascertain the risks of development of vancomycin resistant organisms in the nurseries involved in these trials [18]. Prophylactic IVIG has been shown to result in a 3-4% reduction in the incidence of sepsis but the cost factor is a major deterrent to its routine use [19].…”

Section: Preventionmentioning

confidence: 99%

Newer Concepts and Management of Neonatal Sepsis

Mathai

2002

Medical Journal Armed Forces India

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Despite extensive research into its patho-physiology, investigations and treatment, sepsis remains an important cause of neonatal morbidity and mortality. The inddence in developing countries is 10 times that in the developed world. A large number of pro-and anti-inOammatory cytokines (interleukins, eicosanoids, tumour necrosis factor-alpha, nitric oxide) have been identified, the interplay of which leads to the Systemic InOammatory Response Syndrome (SIRS) which can have devastating consequences on all systems of the body. In Indla the common organisms include Staphy1«occus, E coli, Klebsiella and Candida. A number of maternal and neonatal risk factors have been identified. The Initial signs and symptoms are subtle and can easily be missed. Early investigations and screening tests are important and a promising number of new tests are being studied. The gold standard for diagnosis is a positive culture from a body Ouid or local source in the presence of SIRS. The threshold for starting antibiotics should be low in high-risk neonates and broad spectrum antibiotics covering the likely organisms should be given intravenously in all suspected cases in a hospital setting. This should be continued for at least 24-48 hours (till negative reports are available) in suspected cases and for 3 weeks in proven cases. Prophylaxis is aimed at preventing nosocomial and cross infections. Strict hand.washing, meticulous asepsis protocols, identiOcation of high risk groups and prompt and better screening tests are essential in controlling this problem.

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Section: Preventionmentioning

confidence: 99%

Newer Concepts and Management of Neonatal Sepsis

Mathai

2002

Medical Journal Armed Forces India

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“…Estes estudos foram recentemente revisados pelo Grupo de Revisão Cochrane Neonatal, que concluiu que este uso reduz a incidên-cia de sepse nosocomial por este agente. Entretanto, considerando-se a preocupação quanto ao risco de desenvolvimento de organismos resistentes e, em vista de poucos benefícios clínicos demonstrados, estes revisores sugerem que o uso rotineiro de vancomicina não deva ser praticado 84 .…”

Section: Infusão De Baixas Doses De Vancomicinaunclassified

Neonatal nosocomial infections

Mussi-Pinhata

Nascimento²

2001

J Pediatr (Rio J)

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ResumoObjetivos: realizar revisão sobre infecções hospitalares neonatais, salientando aspectos dos mecanismos de colonização, defesa imunológica e infecção no recém-nascido, dos modos de transmissão, da epidemiologia e da vigilância e prevenção destas infecções. Revisar, ainda, particularidades sobre agentes etiológicos e recomendações preventivas.Métodos: busca eletrônica, nos bancos de dados Medline e LILACS, de artigos publicados nos últimos 10 anos, selecionandose aqueles que trouxessem informações atuais e relevantes.Resultados: as várias peculiaridades que causam maior susceptibilidade à infecção em recém-nascidos e a sobrevivência de recém-nascidos prematuros às custas da permanência em unidades de terapia intensiva neonatal, onde são submetidos a procedimentos invasivos e ao uso de antimicrobianos de largo espectro, são responsáveis por taxas de incidência de infecções hospitalares neonatais tão elevadas quanto 9,3 a 25,6%. Tais infecções atingem pelo menos 50% daqueles de peso ao nascer inferior a 1.500g, causando elevada mortalidade. Recém-nascidos a termo apresentam mais freqüente-mente lesões cutâneas e de tecidos moles, causadas por bactérias gram-positivas. Nas unidades de terapia intensiva, sepse e pneumonia freqüentemente são diagnosticadas (principalmente causadas por S. aureus, S. epidermidis, E. coli, K. pneumonia e E. cloacae).A resistência a múltiplas drogas antimicrobianas tem sido identificada com freqüência crescente. Um programa de vigilância epidemiológica adaptado às características da unidade neonatal permite a identificação de surtos de infecção, o uso racional de antibacterianos e a aplicação de medidas preventivas.Conclusões: as infecções hospitalares neonatais representam problema relevante cujo controle depende de medidas que se aplicam à gestante, ao ambiente hospitalar, à equipe assistencial e ao próprio recém-nascido. Apesar de terem surgido novas propostas para a redução do risco de infecção hospitalar em recém-nascidos pré-termo, estas são de custo elevado e não substituem a vigilância epidemiológica contínua nas unidades neonatais. AbstractObjective: to review the current medical literature on neonatal nosocomial infections, emphasizing aspects of neonatal colonization, immune system and infection mechanisms, modes of transmission, epidemiology, surveillance and prevention of these infections, in addition to assessing peculiarities about etiologic agents and prophylactic recommendations.Sources: electronic search in the Medline and LILACS databases, with selection of the most relevant articles published within the last ten years.Summary of the findings: the several peculiarities that cause greater susceptibility to infection in newborns, and the survival of preterm infants due to the invasive procedures and treatment with broad spectrum antibiotics at intensive care units are responsible for prevalence rates of neonatal nosocomial infections between 9.3 and 25.6%. Neonatal nosocomial infections affect at least 50% of newborns who weigh less than 1500 g, which ends up incre...

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“…Its empiric use in neonates is widespread and can be life-saving [1]. A reported surge in methicillin-resistant Staphylococcus aureus (MRSA) has led to a resurgence of vancomycin use [2].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological Evaluation of Blood Culture Patterns among Neonates Receiving Vancomycin

et al. 2014

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The objective of this study was to assess the frequency of blood culture (BC) collection among neonates who received vancomycin. Demographic, clinical, microbiologic, and pharmacy data were collected for 1275 neonates (postnatal age 0-27 days) who received vancomycin at an Intermountain Healthcare facility between 1/2006 and 9/2011. Neonates treated with vancomycin had a BC collected 94 % (n = 1198) of the time, of which 37 % (n = 448) grew one or more bacterial organisms (BC positive). Of these, 1 % (n = 5) grew methicillin-resistant Staphylococcus aureus (MRSA), 71 % (n = 320) grew coagulase-negative Staphylococci (CoNS), 9 % (n = 40) grew methicillin-sensitive Staphylococcus aureus (MSSA), and 22 % (n = 97) grew other bacterial species (total exceeds 100 % due to co-detection). In patients with negative BC or no BC, vancomycin therapy was extended beyond 72 h 52 % of the time. The median duration of vancomycin therapy for patients with a negative BC was 4 (IQR: 2-10) days. BCs were frequently obtained among neonates who received vancomycin. Vancomycin therapy beyond the conventional 'empiric' treatment window of 48-72 h was common without isolation of resistant grampositive bacteria.

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Vancomycin for prophylaxis against sepsis in preterm neonates

Cited by 47 publications

References 22 publications

Newer Concepts and Management of Neonatal Sepsis

Newer Concepts and Management of Neonatal Sepsis

Neonatal nosocomial infections

Epidemiological Evaluation of Blood Culture Patterns among Neonates Receiving Vancomycin

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