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Pediatr Infect Dis J. 1998 Mar;17(3):179-83.

Selective use of vancomycin to prevent coagulase-negative staphylococcal nosocomial bacteremia in high risk very low birth weight infants.

Author information

  • 1Department of Pediatrics, Louisiana State University Medical Center, Shreveport 71130-3930, USA. RJBAIER@worldnet.att.net

Abstract

OBJECTIVE:

To determine whether vancomycin added to parental nutrition (PN) fluids could prevent nosocomial infections in very low birth weight newborns and which infants would benefit most from prophylaxis.

DESIGN:

Double blind, randomized controlled study.

SETTING AND STUDY POPULATION:

Very low birth weight infants receiving PN in a tertiary neonatal intensive care unit.

METHODS:

Thirty-eight infants with and without central vascular catheters were randomized to receive no medication or 25 microg/ml vancomycin added to PN for the duration of the infant's PN requirements.

RESULTS:

The addition of 25 microg/ml vancomycin to PN prevented bacteremia in very low birth weight infants receiving PN. There was a significant reduction in the number of coagulase-negative staphylococcal (CONS) bacteremias (defined as isolation of the same organism from two positive blood cultures) during PN (5 vs. 0; P = 0.037) as well as the total number of bacteremias and fungemias (9 vs. 1; P = 0.036). The total number of hospital days (108 +/- 13 vs. 76 +/- 6; P = 0.039) were reduced in infants receiving vancomycin. Infants with birth weights of < 1000 g who received corticosteroids for treatment of chronic lung disease benefitted most from treatment. No vancomycin-resistant strains of CONS or enterococci were detected during the study period.

CONCLUSIONS:

Prophylactic treatment with vancomycin effectively prevented CONS bacteremia under the conditions of the study. Its use was most effective in infants with birth weights of <1000 g.

PMID:
9535242
[PubMed - indexed for MEDLINE]
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