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Intravenous rifampicin in neonates with persistent staphylococcal bacteraemia
A Shama1, S K Patole, J S Whitehall
1Department of Neonatology, Kirwan Hospital for Women, Townsville, QLD, Australia.
Acta Paediatrica (Oslo, Norway : 1992)
|August 7, 2002
Summary
Intravenous rifampin effectively clears persistent coagulase-negative staphylococcal (CONS) bacteremia in high-risk neonates. Adding rifampin to vancomycin treatment demonstrated rapid bacterial clearance with no observed adverse effects.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pharmacology
Background:
- Persistent coagulase-negative staphylococcal (CONS) bacteremia poses a significant risk in high-risk neonates.
- Standard vancomycin treatment can lead to prolonged infection duration and potential bacterial resistance.
- Intravenous (IV) vancomycin was administered at 15 mg/kg/24 h with monitored peak and trough concentrations.
Observation:
- Four high-risk neonates (mean birthweight 823 g, mean gestation 25 wk) with persistent CONS bacteremia (>7-10 days) were studied.
- Neonates aged 2-11 days received IV rifampicin (10 mg/kg/12 h for 10 days) in addition to vancomycin.
- Blood isolates included Staphylococcus epidermidis, S. hominis, and S. haemolyticus.
Findings:
- Addition of IV rifampicin led to prompt clearance of bacteremia within 48 hours in three neonates and within 5 days in one neonate.
- No rifampicin-related adverse effects, such as abnormal liver function tests or thrombocytopenia, were observed.
- The combination therapy demonstrated efficacy in treating persistent CONS bacteremia.
Implications:
- IV rifampin may optimize treatment outcomes for persistent CONS bacteremia in neonates.
- Combining rifampin with vancomycin could mitigate the risk of bacterial resistance associated with prolonged vancomycin exposure.
- This therapeutic approach warrants further investigation for managing neonatal staphylococcal infections.