Intravenous rifampicin in neonates with persistent staphylococcal bacteraemia

Acta Paediatr. 2002;91(6):670-3. doi: 10.1080/080352502760069098.

Abstract

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.

Conclusion: 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.

Publication types

  • Case Reports

MeSH terms

  • Bacteremia / diagnosis
  • Bacteremia / drug therapy*
  • Cross Infection / diagnosis
  • Cross Infection / drug therapy*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Infusions, Intravenous
  • Intensive Care Units, Neonatal
  • Male
  • Rifampin / administration & dosage*
  • Severity of Illness Index
  • Staphylococcal Infections / diagnosis
  • Staphylococcal Infections / drug therapy*
  • Treatment Outcome

Substances

  • Rifampin