Prevention of central venous catheter-related coagulase-negative staphylococcal sepsis in neonates

Spafford, Patrick; Sinkin, Robert A.; Cox, Christopher A.; Reubens, Linda J.; Powell, Keith R.

doi:10.1016/s0022-3476(94)70208-x

Cited by 134 publications

(68 citation statements)

References 20 publications

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“…Due to the difference in the intervention used, we were able to combine only the two studies that used vancomycin, 18,20 whereas the third study that used amoxicillin was reported separately. 19 The secondary outcomes in all three studies are described in Table 2.…”

Section: Resultsmentioning

confidence: 99%

“…The meta-analysis of two trials 18,20 that used vancomycin revealed that neonates who had received vancomycin had an 87% reduction in the incidence of sepsis (RR 0.13, 95% CI 0.04 to 0.46) compared with no treatment or placebo (P ¼ 0.002) (Figure 2). By using vancomycin the risk of infection decreased from 23 to 2.4%, with an absolute risk reduction (ARR) or RD of approximately 20% (95% CI À0.29 to À0.11) (P ¼ 0.0001), which yields an NNT equal to 5 (P ¼ 0.0001).…”

Section: Resultsmentioning

confidence: 99%

“…[18][19][20] All three studies were published as full text articles. [18][19][20] Authors of these studies were contacted to obtain additional relevant information.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…[18][19][20] Authors of these studies were contacted to obtain additional relevant information. Vancomycin 18,20 (two studies) and amoxicillin 19 (one study) were used as a prophylactic antibiotic for prevention of CRBSI.…”

Section: Description Of Studiesmentioning

confidence: 99%

“…Spafford et al 20 conducted a randomized, double-masked, controlled trial to determine whether vancomycin added to TPN solution infused via CVL would decrease the incidence of CRBSI. During the 15-month period of enrollment, 84 patients needed CVL placement.…”

Section: Description Of Studiesmentioning

confidence: 99%

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Prophylactic antibiotics in the prevention of catheter-associated bloodstream bacterial infection in preterm neonates: a systematic review

et al. 2008

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Objective: To evaluate the efficacy of prophylactic antibiotics in preventing infection associated with central venous catheters in preterm neonates.Study Design: The search strategy of the Cochrane Neonatal Review Group was used. The following databases were searched: Medline, Cochrane Central Register of Controlled Trials, CINAHL and EMBASE. In addition, we hand-searched abstracts of Pediatric Academic Societies annual meetings published in Pediatric Research (1990 to July 2007 and Canadian Pediatric Society annual meeting proceedings (1990( to July 2007. No language restrictions were applied. Included were randomized controlled trials of antibiotics given prophylactically to prevent infection in preterm infants (<37 completed weeks) less than 1-month old admitted to neonatal intensive care units. Both centrally or peripherally inserted central venous catheters were included. Assessment of methodological quality and extraction of data for included trials was undertaken independently by two authors. When suitable, data from trials were combined in a meta-analysis.Result: A total of three studies were found which addressed the role of prophylactic antibiotics to prevent catheter-related infection in neonates. Two studies used vancomycin as the prophylactic antibiotic and one study used amoxicillin. The meta-analysis of studies that used vancomycin had shown an absolute risk reduction of infection from 23 to 2.4%, which yields a number needed to treat equal to 5 (P ¼ 0.0001). Total duration of catheter stay and mortality, were both similar in the vancomycin and control groups. In the amoxicillin study, catheter-related sepsis was not significantly different between the treatment and control groups (P ¼ 0.40). The rate of colonization, however, was significantly higher in the control group (relative risk 0.48; 95% CI 0.12, 1.35). The incidence of necrotizing enterocolitis, intracranial hemorrhage, thrombosis and deaths were not statistically significant between groups.Conclusion: Prophylactic vancomycin appeared to be effective in preventing catheter-related sepsis in preterm neonates. The potential risks, however, of the emergence of resistance because of prophylactic antibiotics, and their continued effectiveness, need further evaluation, before routine use can be recommended.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…[18][19][20] All three studies were published as full text articles. [18][19][20] Authors of these studies were contacted to obtain additional relevant information.…”

Section: Description Of Studiesmentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

Section: Description Of Studiesmentioning

confidence: 99%

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Prophylactic antibiotics in the prevention of catheter-associated bloodstream bacterial infection in preterm neonates: a systematic review

et al. 2008

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Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in Hospitals

Goldmann

Weinstein²,

Wenzel³

et al. 1996

JAMA

564

119

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Efficacy of a vancomycin solution to prevent bacteremia associated with an indwelling central venous catheter in neutropenic and non-Neutropenic cancer patients

Barriga

Varas

Potı́n

et al. 1997

Med. Pediatr. Oncol.

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We evaluated the efficacy of a vancomycin solution in the prevention of bacteremia caused by vancomycin‐sensitive organisms (VSO) in cancer patients with a tunneled central venous catheter (CVC). Eighty‐three patients who had a single lumen CVC were randomized to use a heparin solution (25 U/ml) for daily catheter flush with (HepVan) or without (Hep) vancomycin, 25 mcg/ml. Febrile episodes were recorded, and central and peripheral blood cultures were drawn before beginning antibiotic therapy. Patients participated in follow‐up for 16,677 catheter days (8,666 Hep and 8,011 HepVan), and 143 febrile episodes were recorded (82 Hep and 61 HepVan). Forty‐four episodes of bacteremia occurred, 23 of them due to VSO (16 occurred in the Hep group and 7 in the HepVan group (P = 0.19). VSO bacteremia occurred in 14 neutropenic (absolute neutrophil count < 500 × 104/l) episodes (7 Hep vs. 7 HepVan) and in 9 non‐neutropenic episodes (9 Hep vs. 0 HepVan; P = 0.013). Vancomycin effectively prevented bacteremia by VSO in non‐neutropenic patients, supporting the idea that intraluminal colonization of indwelling CVCs contributes to bacteremia only in these patients. Med. Pediatr. Oncol. 28:196–200 © 1997 Wiley‐Liss, Inc.

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Prevention of central venous catheter-related coagulase-negative staphylococcal sepsis in neonates

Cited by 134 publications

References 20 publications

Prophylactic antibiotics in the prevention of catheter-associated bloodstream bacterial infection in preterm neonates: a systematic review

Prophylactic antibiotics in the prevention of catheter-associated bloodstream bacterial infection in preterm neonates: a systematic review

Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in Hospitals

Efficacy of a vancomycin solution to prevent bacteremia associated with an indwelling central venous catheter in neutropenic and non-Neutropenic cancer patients

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