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Vancomycin and neonate

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https://www.readbyqxmd.com/read/29770901/factors-impacting-unbound-vancomycin-concentrations-in-neonates-and-young-infants
#1
Anne Smits, Steven Pauwels, Matthijs Oyaert, Nele Peersman, Isabel Spriet, Veroniek Saegeman, Karel Allegaert
Vancomycin pharmacokinetic (PK) and pharmacodynamic (PD) data in neonates are based on total concentrations. However, only unbound vancomycin is pharmacologically active. The objective was to determine vancomycin protein binding and the covariates impacting unbound vancomycin concentration in neonates and young infants. In neonates and young infants to whom vancomycin was administered intermittently for medical indications, total and unbound vancomycin plasma concentrations were determined using LC-MS/MS. Sampling occurred randomly during vancomycin exposure, covering a broad range of concentrations...
May 16, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29750801/streptococcus-agalactiae-carriage-among-pregnant-women-living-in-rio-de-janeiro-brazil-over-a-period-of-eight-years
#2
Ana Caroline N Botelho, Juliana G Oliveira, Andreia P Damasco, Késia T B Santos, Ana Flávia M Ferreira, Gabriel T Rocha, Penélope S Marinho, Rita B G Bornia, Tatiana C A Pinto, Marco A Américo, Sergio E L Fracalanzza, Lúcia M Teixeira
Group B Streptococcus (GBS) carriage by pregnant women is the primary risk factor for early-onset GBS neonatal sepsis. Intrapartum antibiotic prophylaxis (IAP) can prevent this transmission route, and two main approaches are recommended to base the selection of pregnant women to be submitted to IAP: the risk-based and the culture-based strategies. In Brazil, compliance to such recommendations is poor, and not much is known about GBS carriage. In the present study, 3,647 pregnant women living in Rio de Janeiro State, Brazil, were screened for GBS anogenital colonization, over a period of 8 years (2008-2015)...
2018: PloS One
https://www.readbyqxmd.com/read/29744228/successful-treatment-of-high-level-aminoglycoside-resistant-enterococcus-faecalis-bacteremia-in-a-preterm-infant-with-ampicillin-and-cefotaxime
#3
Jennifer Tam, Santina J Lee, Vibhuti Shah, Shaun K Morris
Enterococcal bloodstream infections are usually treated with single-agent antibiotics. In persistent infections, synergistic combination therapy is often required with a beta-lactam and an aminoglycoside antibiotic. High-level aminoglycoside-resistant (HLAR) enterococci are increasingly prevalent and preclude the use of this combination. The use of ampicillin with a third-generation cephalosporin to treat endovascular HLAR Enterococcus infections is becoming more established in the adult population; however, the literature on treatment of such infections in children remains scarce...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29728084/group-b-streptococci-vaginal-colonization-and-drug-susceptibility-pattern-among-pregnant-women-attending-in-selected-public-antenatal-care-centers-in-addis-ababa-ethiopia
#4
Solomon Assefa, Kassu Desta, Tsehaynesh Lema
BACKGROUND: Group B Streptococcus (GBS) is the leading cause of septicemia, meningitis, and pneumonia in neonates. Maternal colonization with GBS is the principal risk factor for early-onset disease in infants. Group B Streptococcus is now an important cause of maternal and neonatal morbidity and mortality in many parts of the world. In Ethiopia, few studies have been done on GBS colonization among pregnant women. The aim of this study was to determine the prevalence of GBS colonization, antimicrobial susceptibility patterns and assess risk factors among pregnant women...
May 4, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29615159/antimicrobial-stewardship-in-neonates-challenges-and-opportunities
#5
Christopher McPherson, Caren Liviskie, Brandy Zeller, Miranda P Nelson, Jason G Newland
Neonatal infections result in significant morbidity and mortality. Antibiotics are vital for the treatment of infections but disrupt the neonatal microbiome, put the infant at risk for an adverse drug reaction, and may lead to the development of antibiotic resistance. Immediately after birth, clinicians must determine which infants require empiric antibiotics. Online risk stratification tools may provide a superior approach to decision trees. In infants who require empiric therapy for early-onset sepsis, ampicillin and an aminoglycoside with dosing based on recent pharmacokinetic studies represents the most appropriate first-line agents; third-generation cephalosporins should be reserved for patients with a high likelihood of Gram-negative meningitis...
March 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29613975/antibiotic-overuse-in-premature-low-birth-weight-infants-in-a-developing-country
#6
Maria S Rueda, Renzo Calderon-Anyosa, Jorge Gonzales, Christie G Turin, Alonso Zea-Vera, Jaime Zegarra, Sicilia Bellomo, Luis Cam, Anne Castaneda, Theresa J Ochoa
BACKGROUND: Neonatal sepsis is a leading cause of child morbidity and mortality, especially in premature and low-birth-weight (LBW) infants. Prompt antibiotic therapy is warranted, but its inappropriate use leads to bacterial resistance and adverse outcomes. Our objective is to describe the antibiotic use for late onset sepsis (LOS) in Peruvian premature infants. METHODS: Prospective study as a secondary analysis of a clinical trial in three Neonatal Care Units in Peru...
April 2, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29605146/principles-and-applications-of-pharmacometrics-in-drug-evaluation-in-children
#7
Stéphanie Leroux, Valéry Elie, Wei Zhao, Sophie Magreault, Evelyne Jacqz-Aigrain
Drug evaluation in children is difficult for many well-identified reasons and many drugs are still used off-label. Innovative approaches are particularly adapted to the paediatric and neonatal populations, as clinical trials are difficult to conduct, need adapted designs in order to define the optimal dosage regimen in many diseases and therapeutic areas. Population approaches to define pharmacokinetics and pharmacokinetic/pharmacodynamics are now more currently used to define dosing regimens, adapted to the different paediatric and neonatal age groups, that allow to increase efficacy and reduce toxicity, by taking into account factors explaining variability in drug response...
February 16, 2018: Thérapie
https://www.readbyqxmd.com/read/29602981/population-pharmacokinetics-of-vancomycin-and-auc-guided-dosing-in-chinese-neonates-and-young-infants
#8
Yewei Chen, Dan Wu, Min Dong, Yiqing Zhu, Jinmiao Lu, Xiaoxia Li, Chao Chen, Zhiping Li
OBJECTIVES: To develop a population pharmacokinetic (PK) model for vancomycin in Chinese neonates and infants less than 2 months of age (young infants) with a wide gestational age range, in order to determine the appropriate dosing regimen for this population. METHODS: We performed a retrospective chart review of patients from the neonatal intensive care unit (NICU) at Children's Hospital of Fudan University to identify neonates and young infants treated with vancomycin from May 2014 to May 2017...
March 30, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29596216/reduction-of-inappropriate-antimicrobial-prescriptions-in-a-tertiary-neonatal-intensive-care-unit-following-antimicrobial-stewardship-care-bundle-implementation
#9
Joseph Y Ting, Vanessa Paquette, Karen Ng, Sarka Lisonkova, Valoria Hait, Sandesh Shivanada, Peter Tilley, Osiovich Horacio, Ashley Roberts
BACKGROUND: Our objective was to evaluate the appropriateness of antibiotic prescriptions in the neonatal intensive care unit (NICU) using standardised criteria and determine the effects of an antimicrobial stewardship programme (ASP) on patterns of antibiotic usage. METHODS: A retrospective audit of antibiotic use from July 2010-June 2013 was conducted, focusing on prescriptions of vancomycin, cefotaxime, meropenem and linezolid for >3 calendar days. We evaluated the appropriateness of each course of antibiotic treatment based on the Centers for Disease Control and Prevention (CDC) 12-Step Guidelines to Prevent Antimicrobial Resistance (Steps 4, 6 and 9)...
March 24, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29588851/vancomycin-resistant-enterococcus-faecium-sequence-type-796-rapid-international-dissemination-of-a-new-epidemic-clone
#10
Andrew A Mahony, Andrew H Buultjens, Susan A Ballard, Elizabeth A Grabsch, Shirley Xie, Torsten Seemann, Rhonda L Stuart, Despina Kotsanas, Allen Cheng, Helen Heffernan, Sally A Roberts, Geoffrey W Coombs, Narin Bak, John K Ferguson, Glen C Carter, Benjamin P Howden, Timothy P Stinear, Paul D R Johnson
Background: Vancomycin-resistant Enterococcus faecium (VRE) is a leading cause of hospital-acquired infections. New, presumably better-adapted strains of VRE appear unpredictably; it is uncertain how they spread despite improved infection control. We aimed to investigate the relatedness of a novel sequence type (ST) of vanB E. faecium - ST796 - very near its time of origin from hospitals in three Australian states and New Zealand. Methods: Following near-simultaneous outbreaks of ST796 in multiple institutions, we gathered then tested colonization and bloodstream infection isolates' antimicrobial resistance (AMR) phenotypes, and phylogenomic relationships using whole genome sequencing (WGS)...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29536341/morbidity-and-mortality-of-coagulase-negative-staphylococcal-sepsis-in-very-low-birth-weight-infants
#11
Joseph B Cantey, Kelsey R Anderson, Ram R Kalagiri, Lea H Mallett
BACKGROUND: Coagulase-negative staphylococci (CoNS) are the most common cause of late-onset sepsis in the neonatal intensive care unit (NICU) and usually require vancomycin treatment. Our objective was to determine whether CoNS are associated with neonatal morbidity and mortality. METHODS: This was a retrospective cohort study of very-low-birth-weight (VLBW, ≤ 1500 g) infants from 1989 to 2015. Exclusion criteria were major congenital anomaly or death within 72 h...
March 13, 2018: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29530119/-clinical-features-of-enterococcus-faecium-meningitis-in-children
#12
Li-Yuan Wang, Xiao-Tang Cai, Zhi-Ling Wang, Shun-Li Liu, Yong-Mei Xie, Hui Zhou
OBJECTIVE: To summarize the clinical features of Enterococcus faecium meningitis in children. METHODS: The clinical data of nine children with Enterococcus faecium meningitis were analyzed. RESULTS: In all the nine children, Enterococcus faecium was isolated from blood, cerebrospinal fluid, or peripherally inserted central catheters; 6 (67%) patients were neonates, 2 (22%) patients were younger than 6 months, and 1 (11%) patient was three years and four months of age...
March 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29506640/a-rare-case-of-complicated-pericardial-effusion-with-elizabethkingia-meningoseptica-from-iran
#13
Hadi Sedigh Ebrahim-Saraie, Hamid Heidari, Reza Khashei, Seyed Hesamedin Nabavizadeh
Infections due to Elizabethkingia meningoseptica, a Gram-negative oxidative bacterium are frequently founded in neonatal and immunocompromised individuals. The notable characteristic of this organism is its multi-drug resistance to common antibiotics used for infections caused by Gram-negative bacteria. We report a rare case of complicated pericardial effusion due to E. meningoseptica in a 2-year-old boy, who was admitted with chief complaints of fever and tachypnea (mentioned by his parents) and suffered from a rare lung malignancy (lymphangioleiomyomatosis)...
February 28, 2018: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/29495915/enhanced-vancomycin-elimination-in-an-infant-following-an-unsuccessful-gastroschisis-repair-surgery
#14
Leesa Prunty, David Miskell
OBJECTIVE: To report the case of an infant who required high-dose vancomycin therapy after an unsuccessful gastroschisis repair surgery. CASE SUMMARY: An infant born at 35 weeks and 5 days of gestation underwent a gastroschisis repair on day of life 47. The repair was unsuccessful causing fluid backup and accumulation into the stomach. A replogle was placed to allow for suctioning of this fluid. During this admission, the patient received 3 courses of vancomycin...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29488547/-evaluation-of-antimicrobial-consumption-in-a-neonatology-unit-a-team-work-to-promote-the-rational-use-of-antibiotics
#15
Elisa Jiménez, Nicolás Valls, Patricio Astudillo, Cristian Valls, Gabriel Cavada, Alejandra Sandoval, Angélica Alegría, Gabriela Ortega, Daniela Núñez, Patricia Mena
BACKGROUND: Antibiotics (ATB) are drugs widely used in hospitalized newborns. The indiscriminate use of ATBs promote the rise of resistant bacteria to the most commonly indicated antimicrobials. In addition, ATB prescription presents associations to morbidity, such as bronchopulmonary dysplasia, necrotizing enterocolitis, late sepsis and even death. All of the above leads to an increase in health care costs. AIM: To record and to evaluate trends of antibiotic use over time in hospitalized NB in the Neonatology Unit at Dr...
December 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/29475199/the-role-of-a-single-dose-of-vancomycin-in-reducing-clinical-sepsis-in-premature-infants-prior-to-removal-of-peripherally-inserted-central-catheter-a-retrospective-study
#16
Vidit Bhargava, Lovya George, Michael Malloy, Rafael Fonseca
OBJECTIVE:  Peripherally inserted central catheter (PICC) line removal is associated with bloodstream infections and clinical sepsis. We aim to investigate the role of a single prophylactic dose of vancomycin in decreasing the incidence of central line associated bloodstream infection associated with PICC removal. METHODS:  A retrospective chart review of patients in the neonatal intensive care unit was conducted. Patients were divided into two study groups based on whether a single dose of vancomycin was administered (exposed) or not (nonexposed)...
February 23, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29443752/the-first-case-report-of-enterococcus-gallinarum-meningitis-in-neonate-a-literature-review
#17
Xiaoquan Li, Shujuan Fan, Xiaojie Lin, Li Liu, Jie Zheng, Xihui Zhou, Axel Heep
RATIONALE: Enterococcus gallinarum meningitis (EGM) is rarely found in normal adults and even rarer in children. To our knowledge, EGM in neonate has not been reported previously. PATIENTS CONCERNS: Here we reported the first case of EGM in neonate. Prolonged fever was the only manifestation for the case after admission. DIAGNOSES: Cerebrospinal fluid cultures showed that the isolate was Enterococcus gallinarum and sensitive to linezolid. INTERVENTIONS: Ceftriaxone, beta lactam type, and vancomycin were used respectively, but not effective...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29358290/evaluating-the-relationship-between-vancomycin-trough-concentration-and-24-hour-area-under-the-concentration-time-curve-in-neonates
#18
Sheng-Hsuan Tseng, Chuan Poh Lim, Qi Chen, Cheng Cai Tang, Sing Teang Kong, Paul Chi-Lui Ho
Bacterial sepsis is a major cause of morbidity and mortality in neonates, especially those involving methicillin-resistant Staphylococcus aureus (MRSA). Guidelines by the Infectious Diseases Society of America recommend the vancomycin 24-h area under the concentration-time curve to MIC ratio (AUC24 /MIC) of >400 as the best predictor of successful treatment against MRSA infections when the MIC is ≤1 mg/liter. The relationship between steady-state vancomycin trough concentrations and AUC24 values (mg·h/liter) has not been studied in an Asian neonatal population...
April 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29340851/comparison-of-antibiotic-dosing-recommendations-for-neonatal-sepsis-from-established-reference-sources
#19
T B Y Liem, E M A Slob, J U M Termote, T F W Wolfs, A C G Egberts, C M A Rademaker
Background Incorrect dosing is the most frequent prescribing error in neonatology, with antibiotics being the most frequently prescribed medicines. Computer physician order entry and clinical decision support systems can create consistency contributing to a reduction of medication errors. Although evidence-based dosing recommendations should be included in such systems, the evidence is not always available and subsequently, dosing recommendations mentioned in guidelines and textbooks are often based on expert opinion...
January 16, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29319262/successful-management-of-elizabethkingia-meningoseptica-meningitis-with-intraventricular-vancomycin
#20
Rajeev Soman, Umang Agrawal, Mitesh Suthar, Ketan Desai, Anjali Shetty
Elizabethkingia meningoseptica, formerly Chryseobacterium meningosepticum usually causes neonatal meningitis and is a rare cause of nosocomial meningitis in adults. E. meningoseptica is resistant to most antibiotics, and the use of inactive drugs as empirical therapy may contribute to poor outcome in many patients. Vancomycin, alone or in combination with rifampicin, has been successful in the treatment of meningitis in infants1. We present a case of E. meningoseptica meningitis in an adult who was treated initially with intravenous vancomycin and oral rifampicin, but did not respond to the treatment...
October 2017: Journal of the Association of Physicians of India
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