Sandoval Alejandra, Cofré Fernanda, Delpiano Luis, Izquierdo Giannina, Labraña Yenis, Reyes Alejandra
Rev Chilena Infectol. 2015 Apr;32(2):182-9. doi: 10.4067/S0716-10182015000300007.
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.
在新生儿重症监护病房（NICUs）中，万古霉素已被使用了50多年，作为晚发性败血症的首选治疗药物，主要是因为凝固酶阴性葡萄球菌（CoNS）很常见，尽管其毒力较低且与暴发性败血症的关联不常见，但大多对苯唑西林耐药。由于包括其高药代动力学变异性、难以达到治疗性血浆药物浓度以及最低抑菌浓度（MIC）逐渐增加等多种因素，万古霉素在新生儿重症监护病房的使用受到了挑战。随着MIC较高的CoNS的增加以及由耐药革兰氏阴性杆菌和念珠菌引起的感染的增加，应该重新考虑将万古霉素作为一线治疗药物。新生儿感染的表现与其他人群不同，我们认为将苯唑西林作为晚发性败血症的一线抗菌治疗药物至关重要。
