Combination of vancomycin and rifampicin for the treatment of persistent coagulase-negative staphylococcal bacteremia in preterm neonates

Rodriguez-Guerineau, Luciana; Salvia-Roiges, M. D.; León-Lozano, Marisol; Rodríguez-Miguélez, José Manuel; J, Figueras Aloy

doi:10.1007/s00431-012-1927-x

Cited by 6 publications

(5 citation statements)

References 16 publications

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“…A retrospective single-centre study in neonates (5–37 days old, n = 10) with persistent CoNS bacteraemia (LONS) investigated the addition of rifampicin to vancomycin for infection resolution [ 33 ]. Bacteraemia persisted for a median of 9 days (range 6–19) until the initiation of rifampicin.…”

Section: Resultsmentioning

confidence: 99%

Reviewing the WHO guidelines for antibiotic use for sepsis in neonates and children

Fuchs

Bielicki

Mathur

et al. 2018

Paediatrics and International Child Health

142

128

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BackgroundGuidelines from 2005 for treating suspected sepsis in low- and middle-income countries (LMIC) recommended hospitalisation and prophylactic intramuscular (IM) or intravenous (IV) ampicillin and gentamicin. In 2015, recommendations when referral to hospital is not possible suggest the administration of IM gentamicin and oral amoxicillin. In an era of increasing antimicrobial resistance, an updated review of the appropriate empirical therapy for treating sepsis (taking into account susceptibility patterns, cost and risk of adverse events) in neonates and children is necessary.MethodsSystematic literature review and international guidelines were used to identify published evidence regarding the treatment of (suspected) sepsis.ResultsFive adequately designed and powered studies comparing antibiotic treatments in a low-risk community in neonates and young infants in LMIC were identified. These addressed potential simplifications of the current WHO treatment of reference, for infants for whom admission to inpatient care was not possible. Research is lacking regarding the treatment of suspected sepsis in neonates and children with hospital-acquired sepsis, despite rising antimicrobial resistance rates worldwide.ConclusionsCurrent WHO guidelines supporting the use of gentamicin and penicillin for hospital-based patients or gentamicin (IM) and amoxicillin (oral) when referral to a hospital is not possible are in accordance with currently available evidence and other international guidelines, and there is no strong evidence to change this. The benefit of a cephalosporin alone or in combination as a second-line therapy in regions with known high rates of non-susceptibility is not well established. Further research into hospital-acquired sepsis in neonates and children is required.

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Section: Resultsmentioning

confidence: 99%

Reviewing the WHO guidelines for antibiotic use for sepsis in neonates and children

Fuchs

Bielicki

Mathur

et al. 2018

Paediatrics and International Child Health

142

128

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“…Within the University of Utah Hospital system, there are signs of improvement in the antibiotic stewardship of vancomycin where the DOT/1,000 PD for vancomycin use was 37.3% lower in unconfirmed compared to confirmed cases of LOS with a significant reduction in empiric use over time ( Table 4 ). Rifampin was often combined with vancomycin to treat persistent CoNS infections within the University of Utah Hospital system—there is some limited evidence that this strategy is effective (Acar et al, 1983; Shama et al, 2002; van der Lugt et al, 2010; Rodriguez-Guerineau et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Treatment of Suspected and Confirmed Neonatal Sepsis Within 28 Days of Birth: A Retrospective Analysis

et al. 2019

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Neonatal sepsis causes significant mortality and morbidity worldwide. Diagnosis is usually confirmed via blood culture results. Blood culture sepsis confirmation can take days and suffer from contamination and false negatives. Empiric therapy with antibiotics is common. This study aims to retrospectively describe and compare treatments of blood culture-confirmed and unconfirmed, but suspected, sepsis within the University of Utah Hospital system. Electronic health records were obtained from 1,248 neonates from January 1, 2006, to December 31, 2017. Sepsis was categorized into early-onset (≤3 days of birth, EOS) and late-onset (>3 and ≤28 days of birth, LOS) and categorized as culture-confirmed sepsis if a pathogen was cultured from the blood and unconfirmed if all blood cultures were negative with no potentially contaminated blood cultures. Of 1,010 neonates in the EOS cohort, 23 (2.3%) were culture-confirmed, most with Escherichia coli (42%). Treatment for unconfirmed EOS lasted an average of 6.1 days with primarily gentamicin and ampicillin while confirmed patients were treated for an average of 12.3 days with increased administration of cefotaxime. Of 311 neonates in the LOS cohort, 62 (20%) were culture-confirmed, most culturing coagulase negative staphylococci (46%). Treatment courses for unconfirmed LOS lasted an average of 7.8 days while confirmed patients were treated for an average of 11.4 days, these patients were primarily treated with vancomycin and gentamicin. The use of cefotaxime for unconfirmed EOS and LOS increased throughout the study period. Cefotaxime administration was associated with an increase in neonatal mortality, even when potential confounding factors were added to the logistic regression model (adjusted odds ratio 2.8, 95%CI [1.21, 6.88], p = 0.02). These results may not be generalized to all hospitals and the use of cefotaxime may be a surrogate for other factors. Given the low rate of blood culture positive diagnosis and the high exposure rate of empiric antibiotics, this patient population might benefit from improved diagnostics with reevaluation of antibiotic use guidelines.

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“…S. warneri [253][254][255] and S. capitis [256,257] have also joined the list with several isolates resistant to vancomycin, generating outbreaks especially in neonatal units, where S. epidermidis resistant isolates are also frequently found [258]. Fortunately, vancomycin remains an effective antibiotic against most of the CoNS isolates [189,222,245,259], being on the top list of antibiotics used to fight these infections, either alone or in combination with other antibiotics as cefazolin [209], rifampicin [213,260], and fosfomycin [261], among others. Rifampicin is also frequently used to treat staphylococcal infections; however, this antibiotic is associated with the rapid development of resistance when used alone and, as such, it should be used as part of a combined therapy [262][263][264].…”

Section: Resistance To Other Antibioticsmentioning

confidence: 99%

Virulence Factors in Coagulase-Negative Staphylococci

et al. 2021

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Coagulase-negative staphylococci (CoNS) have emerged as major pathogens in healthcare-associated facilities, being S. epidermidis, S. haemolyticus and, more recently, S. lugdunensis, the most clinically relevant species. Despite being less virulent than the well-studied pathogen S. aureus, the number of CoNS strains sequenced is constantly increasing and, with that, the number of virulence factors identified in those strains. In this regard, biofilm formation is considered the most important. Besides virulence factors, the presence of several antibiotic-resistance genes identified in CoNS is worrisome and makes treatment very challenging. In this review, we analyzed the different aspects involved in CoNS virulence and their impact on health and food.

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Combination of vancomycin and rifampicin for the treatment of persistent coagulase-negative staphylococcal bacteremia in preterm neonates

Abstract: Our study provides data supporting the safety and efficacy of vancomycin-rifampicin combination for the treatment of persistent coagulase-negative staphylococcal bacteremia in preterm neonates.

Cited by 6 publications

References 16 publications

Reviewing the WHO guidelines for antibiotic use for sepsis in neonates and children

Reviewing the WHO guidelines for antibiotic use for sepsis in neonates and children

Antibiotic Treatment of Suspected and Confirmed Neonatal Sepsis Within 28 Days of Birth: A Retrospective Analysis

Virulence Factors in Coagulase-Negative Staphylococci

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