title: [Reinstating cloxacilin for empiric antibiotic in late-onset sepsis].
abstract: Vancomycin has been used for more than 50 years in neonatal intensive care units (NICUs) as the therapy of choice for late-onset sepsis, mainly because Coagulase negative Staphylococci (CoNS) are common and mostly resistant to oxacyllin despitelow virulence and unusual association with fulminant sepsis. CUs due to several factors including its high pharmacokinetic variability, difficulty in reaching therapeutic plasmatic drug concentrations and progressively increasing minimum inhibitory concentrations (MIC). The increase of CoNS with higher MICs as well as the rise of infections caused by resistant gram-negative bacilli and candida should move to reconsider Vancomycin as first line treatment. Infections in neonates have a different behavior than in other populations and we consoder of utmost importance to consider the use of oxacyllin as first line antimicrobial therapy for late-onset sepsis.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Sandoval
authors.forename: Fernanda
authors.initials: F
authors.lastname: Cofré
authors.forename: Luis
authors.initials: L
authors.lastname: Delpiano
authors.forename: Giannina
authors.initials: G
authors.lastname: Izquierdo
authors.forename: Yenis
authors.initials: Y
authors.lastname: Labraña
authors.forename: Alejandra
authors.initials: A
authors.lastname: Reyes
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003023:Cloxacillin / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D003030:Coagulase; D058492:Drug Repositioning; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D010818:Practice Patterns, Physicians'; D018805:Sepsis / Q000188:drug therapy* / Q000382:microbiology; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D014640:Vancomycin / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D003030:Coagulase; D014640:Vancomycin; D003023:Cloxacillin