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

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Abstract

Coagulase-negative staphylococci are the most common cause of late-onset sepsis in premature neonates. The optimal approach in persistent coagulase-negative staphylococcal bacteremia, despite adequate treatment with glycopeptides, is not well established. A retrospective study was conducted on preterm neonates with persistent coagulase-negative staphylococcal bacteremia treated with the combination of vancomycin–rifampicin. Ten cases were included, with a median gestational age of 26 weeks (range 24 weeks + 3 days–31 weeks + 4 days, interquartile range 25 weeks + 3 days–29 weeks + 3 days) and a median birth weight of 715 g (range 555–2,030). The median age at the onset of infection was 9 days (range 5–37). The most frequent clinical presentation was apnea or increased ventilatory support. Bacteremia persisted for a median of 9 (range 6–19) days until rifampicin initiation. Bacteremia was resolved in all cases on vancomycin–rifampicin with no serious side effects. Conclusion: 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.

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The authors report no conflict of interest or financial interest.

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Authors and Affiliations

  1. Department of Neonatology, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Hospital Clínic- Hospital Sant Joan de Déu, University of Barcelona, Villarroel No. 170, 08036, Barcelona, Spain

    Luciana Rodriguez-Guerineau, María Dolors Salvia-Roigés, Marisol León-Lozano, José Manuel Rodríguez-Miguélez & Josep Figueras-Aloy

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  1. Luciana Rodriguez-Guerineau
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  2. María Dolors Salvia-Roigés
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  3. Marisol León-Lozano
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  4. José Manuel Rodríguez-Miguélez
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  5. Josep Figueras-Aloy
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Correspondence to Luciana Rodriguez-Guerineau.

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Rodriguez-Guerineau, L., Salvia-Roigés, M.D., León-Lozano, M. et al. Combination of vancomycin and rifampicin for the treatment of persistent coagulase-negative staphylococcal bacteremia in preterm neonates. Eur J Pediatr 172, 693–697 (2013). https://doi.org/10.1007/s00431-012-1927-x

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  • DOI: https://doi.org/10.1007/s00431-012-1927-x

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