Journal
ACTA PAEDIATRICA
Volume 91, Issue 6, Pages 670-673Publisher
TAYLOR & FRANCIS AS
DOI: 10.1080/080352502760069098
Keywords
bacteraemia; neonates; persistent; rifampicin; staphylococci
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Addition of intravenous rifampin is reported to be useful in prompt clearance of persistent coagulase negative staphylococcal (CONS) bacteraemia in high-risk neonates. Four neonates (mean birthweight 823 g, mean gestation 25 wk) with persistent CONS bacteraemia for > 7-10 d (mean 11) were treated with i.v. rifampicin (10 mg/kg/12 h x 10 d) while continuing vancomycin 15 mg/kg/24 h). Their age at time of infection ranged from 2 to 11 d. The mean (range) vancomycin peak and trough concentrations were 29 (25-35) and 6 (4-10) mug/ml. respectively. The blood isolates were Staphylococcus epidermidis. S. hominis, and S. haemolyticus. Addition of rifampicin was associated with prompt clearance of bacteraemia within 48 h (n = 3) and 5 d (n- 1). Rifampicin-related adverse effects such as abnormal liver function tests and thrombocytopenia did not occur. Conclusion: Addition of i.v. rifamipicin to vancomycin may optimize the outcome of persistent CONS bacteraemia and the risk of bacterial resistance related to prolonged exposure to vancomycin.
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