Evaluation of Empiric Nafcillin Versus Vancomycin for Suspected Late Onset Sepsis in the Neonatal Intensive Care Unit
Year: 2025
Type: article
Study design: Observational Study
Abstract: OBJECTIVE To compare clinical outcomes in neonates receiving empiric vancomycin or nafcillin containing regimens for neonatal late onset sepsis (nLOS). METHODS This retrospective study evaluated neonates > 72 hours of age initiated on vancomycin/gentamicin (VANC) or nafcillin/gentamicin (NAF) for suspected nLOS. The primary composite endpoint was clinical worsening, defined as a composite of increased respiratory support or vasopressor requirement, both within the first 24 hours, or prolonged bacteremia. Secondary endpoints included acute kidney injury, methicillin-resistant Staphylococcus aureus colonization, deep-seated infection, and mortality. RESULTS The final cohort included 97 neonates (46 VANC, 51 NAF). There was no difference in the clinical worsening composite (VANC 15.2% vs NAF 15.7%; p = 0.95) or in the individual components of the composite. Secondary endpoints did not yield statistically significant differences. CONCLUSIONS Use of nafcillin as the Gram-positive empiric treatment agent did not result in increased clinical worsening compared to vancomycin at our institution.
Authors: Sarah Hanson, Jennifer Barnes, Jeanne B. Forrester, James E. Jones, Lee E. Morris, Rupal M. Patel
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4417330752
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