Vancomycin use in pediatric neurosurgery patients

被引:22
作者
Shah, SS [1 ]
Sinkowitz-Cochran, RL [1 ]
Keyserling, HL [1 ]
Jarvis, WR [1 ]
机构
[1] Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA
关键词
D O I
10.1016/S0196-6553(99)70025-8
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Objective: The objective of this article is to describe a pediatric neurosurgery patient population receiving vancomycin and examine the indications for and appropriateness of vancomycin use. Methods: A cross-sectional study was performed on the pediatric neurosurgery patients at Egleston Children's Hospital who received vancomycin from January 1 through December 31, 1996. Vancomycin use was compared with the Centers for Disease Control and Prevention Hospital Infection Control Practices Advisory Committee recommendations for vancomycin use. Results: Thirty patients received 115 doses of vancomycin. The median patient age was 8.0 years, and 17 (56.7%) were male. Vancomycin was used for prophylaxis in 28 (93.3%) patients and empiric therapy in 3 (10.0%) patients; one patient received vancomycin for surgical prophylaxis followed by empiric therapy for suspected meningitis. Vancomycin prophylaxis was initiated after the incision in 6 (21.4%) patients and was continued as prophylaxis for more than one dose in 26 (92.9%) patients. Conclusions: Vancomycin was used primarily as surgical prophylaxis in pediatric neurosurgery patients, and use was not consistent with the Hospital Infection Control Practices Advisory Committee recommendations. These data suggest that for certain subpopulations, such as pediatric neurosurgery patients, there is a need for more specialized recommendations. Furthermore, prudent vancomycin use is warranted to successfully decrease the risk of further emergence of vancomycin resistance. Because vancomycin use may be prevalent in this population, assessment of vancomycin use in pediatric neurosurgery patients followed by establishment of vancomycin clinical guidelines may help improve the appropriateness of vancomycin use in this population.
引用
收藏
页码:482 / 487
页数:6
相关论文
共 33 条
[21]   TRANSFERABLE VANCOMYCIN AND TEICOPLANIN RESISTANCE IN ENTEROCOCCUS-FAECIUM [J].
LECLERCQ, R ;
DERLOT, E ;
WEBER, M ;
DUVAL, J ;
COURVALIN, P .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1989, 33 (01) :10-15
[22]  
LIVINGSTON RA, 1991, PEDIATR RES, V29, pA178
[23]   HOSPITAL-ACQUIRED INFECTION WITH VANCOMYCIN-RESISTANT ENTEROCOCCUS-FAECIUM TRANSMITTED BY ELECTRONIC THERMOMETERS [J].
LIVORNESE, LL ;
DIAS, S ;
SAMEL, C ;
ROMANOWSKI, B ;
TAYLOR, S ;
MAY, P ;
PITSAKIS, P ;
WOODS, G ;
KAYE, D ;
LEVISON, ME ;
JOHNSON, CC .
ANNALS OF INTERNAL MEDICINE, 1992, 117 (02) :112-116
[25]   OUTBREAK OF VANCOMYCIN-RESISTANT, AMPICILLIN-RESISTANT, AND AMINOGLYCOSIDE-RESISTANT ENTEROCOCCUS-FAECIUM BACTEREMIA IN AN ADULT ONCOLOGY UNIT [J].
MONTECALVO, MA ;
HOROWITZ, H ;
GEDRIS, C ;
CARBONARO, C ;
TENOVER, FC ;
ISSAH, A ;
COOK, P ;
WORMSER, GP .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1994, 38 (06) :1363-1367
[26]  
NOBLE WC, 1992, FEMS MICROBIOL LETT, V93, P195
[27]  
PONS VG, 1993, NEUROSURGERY, V33, P416
[28]   Emergence of vancomycin resistance in the genus Streptococcus: Characterization of a vanB transferable determinant in Streptococcus bovis [J].
Poyart, C ;
Pierre, C ;
Quesne, G ;
Pron, B ;
Berche, P ;
TrieuCuot, P .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1997, 41 (01) :24-29
[29]  
RUBIN LG, 1992, INFECT CONT HOSP EP, V13, P700
[30]  
SHAPIRO M, 1991, REV INFECT DIS, V13, pS858