Related Experiment Video
Updated: Sep 13, 2025
A Reference Broth Microdilution Method for Dalbavancin In Vitro Susceptibility Testing of Bacteria that Grow Aerobically
Published on: September 9, 2015
Retrospective Evaluation of Empiric Vancomycin Therapy for Infectious Workups in Relation to Methicillin-Resistant
Emma Rednour1, Brianna Hemmann1
1Pharmacy, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Objectives:
This study evaluated empiric antibiotic prescribing patterns in relation to methicillin-resistant Staphylococcus aureus (MRSA) risk factors in infants with potential late-onset sepsis (LOS). Secondarily, this study evaluated rates of escalation and de-escalation from initial antibiotic choice in patients who received at least 5 days of therapy.
Methods:
This was a retrospective study of infants admitted to the neonatal intensive care unit (NICU) from December 1, 2022, to May 31, 2023. Infants at least 3 days old who received antibiotics for an infectious workup were included. The prevalence of risk factors for MRSA, including low birth weight, prematurity, outborn status, length of stay, parenteral nutrition, presence of indwelling lines, and history of MRSA-positive blood culture or colonization, was compared between patients who received vancomycin empirically or an alternative agent.
Results:
A total of 143 blood cultures were obtained from 95 patients who received antibiotics for an infectious workup during the study period. Group 1 received vancomycin and included 51 (36%) blood cultures. Group 2 received an alternative agent and included 92 (64%) blood cultures. Patients in group 1 had higher rates of every MRSA risk factor included in this study, except for patients who were outborn. Group 1 also averaged a higher total number of MRSA risk factors per patient than group 2 (4.88 vs 2.53; p < 0.001).
Conclusion:
This institution uses MRSA risk factors to determine empiric antimicrobial therapy in suspected LOS. Further studies are needed to determine the relationship between the studied risk factors and incidence of MRSA infection.
Insights
Neonatal intensive care unit (NICU) antibiotic choices for late-onset sepsis (LOS) align with methicillin-resistant Staphylococcus aureus (MRSA) risk factors. Vancomycin use was higher in infants with more MRSA risk factors, indicating tailored empiric therapy.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pharmacology
Background:
- Late-onset sepsis (LOS) in neonates poses significant treatment challenges.
- Empiric antibiotic selection requires careful consideration of potential pathogens, including methicillin-resistant Staphylococcus aureus (MRSA).
- Identifying and utilizing MRSA risk factors can optimize initial antibiotic choices.
Purpose of the Study:
- To evaluate empiric antibiotic prescribing patterns for neonatal late-onset sepsis (LOS) in relation to methicillin-resistant Staphylococcus aureus (MRSA) risk factors.
- To assess the secondary outcomes of antibiotic escalation and de-escalation in neonates receiving prolonged therapy.
Main Methods:
- Retrospective study of infants admitted to the neonatal intensive care unit (NICU) between December 2022 and May 2023.
- Included infants aged at least 3 days receiving antibiotics for suspected infection.
- Compared the prevalence of MRSA risk factors (e.g., prematurity, indwelling lines) between infants receiving vancomycin versus alternative empiric antibiotics.
Main Results:
- Of 95 infants receiving antibiotics, 51 (36%) received vancomycin (Group 1) and 92 (64%) received an alternative agent (Group 2).
- Infants in Group 1 (vancomycin) exhibited higher rates of most studied MRSA risk factors compared to Group 2.
- The average number of MRSA risk factors per patient was significantly higher in Group 1 (4.88) than Group 2 (2.53; p < 0.001).
Conclusions:
- The institution's practice aligns with using MRSA risk factors to guide empiric antimicrobial therapy for suspected LOS in neonates.
- Further research is warranted to establish a direct correlation between these specific risk factors and the incidence of MRSA infections.
Related Concept Videos
01:28Antimicrobial Effectiveness
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:26Urine Studies II: Urine Culture and Sensitivity Test
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care