ArticleThe Pediatric infectious disease journal2015
No survival benefit with empirical vancomycin therapy for coagulase-negative staphylococcal bloodstream infections in infants.
Article in The Pediatric infectious disease journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 46 citations in OpenAlex.
- Heterogeneity of Critical Organ Dysfunction During Late-Onset Bacteremia in Preterm Infants.JAMA network open · 2026Observational
- CoNS blood culture isolates from very preterm infants: antibiotic susceptibility, synergy testing andJAC-antimicrobial resistance · 2026Article
- Evaluation of Empiric Nafcillin Versus Vancomycin for Suspected Late Onset Sepsis in the Neonatal Intensive Care Unit.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Antibiotic exposure and infection epidemiology among newborns with congenital diaphragmatic hernia.Journal of perinatology : official journal of the California Perinatal Association · 2025Observational
- Vancomycin Area Under the Curve to Minimum Inhibitory Concentration Ratio for Treatment Effectiveness in Pediatric and Neonatal Staphylococcal Infections: A Systematic Review.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2025Article
- Variation in antibiotic consumption in very preterm infants-a 10 year population-based study.The Journal of antimicrobial chemotherapy · 2024Article
- Estimating antibiotic coverage from linked microbiological and clinical data from the Swiss Paediatric Sepsis Study to support empiric antibiotic regimen selection.Frontiers in pediatrics · 2023Article
- Practice Summary of Antimicrobial Therapy for Commonly Encountered Conditions in the Neonatal Intensive Care Unit: A Canadian Perspective.Frontiers in pediatrics · 2022Review
- Infection control and other stewardship strategies in late onset sepsis, necrotizing enterocolitis, and localized infection in the neonatal intensive care unit.Seminars in perinatology · 2020Article
- Management of early- and late-onset sepsis: results from a survey in 80 German NICUs.Infection · 2019Article
- Challenges and opportunities for antibiotic stewardship among preterm infants.Archives of disease in childhood. Fetal and neonatal edition · 2019Review
- Antibiotic Treatment of Suspected and Confirmed Neonatal Sepsis Within 28 Days of Birth: A Retrospective Analysis.Frontiers in pharmacology · 2019Article
- [Research advances in rational use of antibiotics in neonates].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2018Article
- Morbidity and mortality of coagulase-negative staphylococcal sepsis in very-low-birth-weight infants.World journal of pediatrics : WJP · 2018Article
- Gram-Positive Bacterial Infections: Research Priorities, Accomplishments, and Future Directions of the Antibacterial Resistance Leadership Group.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Review
- Prevention and treatment of neonatal nosocomial infections.Maternal health, neonatology and perinatology · 2017Review
- Heart rate characteristic index monitoring for bloodstream infection in an NICU: a 3-year experience.Archives of disease in childhood. Fetal and neonatal edition · 2016Article
- Adverse consequences of neonatal antibiotic exposure.Current opinion in pediatrics · 2016Review
- Appropriate Use of Vancomycin in NICU Despite Free-for-All Policy.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAGArticle
- Antimicrobial use for treatment of healthcare-associated infections and bacterial resistance in a reference neonatal unit.Jornal de pediatriaArticle
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10 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundCoagulase-negative Staphylococcus (CoNS) is the most common cause of bloodstream infections (BSI) in hospitalized infants. CoNS BSI is most reliably treated with vancomycin; however, concerns about side effects and promoting resistance often delay empirical vancomycin therapy until culture results become available.
methodsAll infants with CoNS BSI discharged from 348 neonatal intensive care units managed by the Pediatrix Medical Group from 1997 to 2012 were identified. Empirical vancomycin therapy was defined as vancomycin exposure on the day of the first positive blood culture. Delayed vancomycin therapy was defined as vancomycin exposure 1-3 days after the first positive blood culture. We used multivariable logistic regression with random effects for site to evaluate the association between the use of empirical vancomycin therapy versus delayed vancomycin therapy and 30-day mortality, controlling for gestational age, small-for-gestational age status, postnatal age on the day of the first positive culture, oxygen requirement, ventilator support and inotropic support on the day the first positive culture was obtained.
resultsA total of 4364 infants with CoNS BSI were identified; 2848 (65%) were treated with empirical vancomycin. The median postnatal age at first positive culture was 14 days (interquartile range: 9, 21). Unadjusted 30-day mortality was similar for infants treated with empirical vancomycin and infants treated with delayed vancomycin therapy [166/2848 (6%) vs. 69/1516 (4%); P = 0.08]. There was no significant difference in 30-day mortality on multivariable analysis [odds ratio: 1.14 (0.84, 1.56)]. The median duration of bacteremia was 1 day longer for infants with delayed vancomycin therapy [4 days (interquartile range: 2, 6) vs. 3 days (2, 5); P < 0.0001].
conclusionsThe median duration of bacteremia was 1 day longer in infants with CoNS BSI who received delayed vancomycin therapy. Despite this finding, empirical vancomycin therapy for CoNS BSI was not associated with improved mortality.
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