Intravenous rifampicin in neonates with persistent staphylococcal bacteraemia.
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) microg/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.


CONCLUSIONS
Addition of i.v. rifampicin to vancomycin may optimize the outcome of persistent CONS bacteraemia and the risk of bacterial resistance related to prolonged exposure to vancomycin.
Shama
A
A
Department of Neonatology, Kirwan Hospital for Women, Townsville, QLD, Australia.
Patole
S K
SK
Whitehall
J S
JS
D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy*; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007262:Infusions, Intravenous; D007363:Intensive Care Units, Neonatal; D008297:Male; D012293:Rifampin / Q000008:administration & dosage*; D012720:Severity of Illness Index; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
D012293:Rifampin