Articles: vancomycin-administration-dosage.
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J Neurosurg Pediatr · Dec 2018
Topical vancomycin surgical prophylaxis in pediatric open craniotomies: an institutional experience.
OBJECTIVETopical antimicrobial compounds are safe and can reduce cost and complications associated with surgical site infections (SSIs). Topical vancomycin has been an effective tool for reducing SSIs following routine neurosurgical procedures in the spine and following adult craniotomies. However, widespread adoption within the pediatric neurosurgical community has not yet occurred, and there are no studies to report on the safety and efficacy of this intervention. ⋯ There were no significant differences in risk factors for SSI between cohorts. There were no complications associated with topical vancomycin use. CONCLUSIONSRoutine topical vancomycin administration during closure of open craniotomies can be a safe and effective tool for reducing SSIs in the pediatric neurosurgical population.
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In this in-silico study, we investigate the clinical utility of target-controlled infusion for antibiotic dosing in an intensive care unit setting using vancomycin as a model compound. We compared target-controlled infusion and adaptive target-controlled infusion, which combines target-controlled infusion with data from therapeutic drug monitoring, with conventional (therapeutic drug monitoring-based) vancomycin dosing strategies. ⋯ Our study shows that adaptive target-controlled infusion has the potential to become a practical tool for patient-tailored antibiotic dosing in the intensive care unit.
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Reg Anesth Pain Med · Oct 2018
Local Vancomycin Effectively Reduces Surgical Site Infection at Implant Site in Rodents.
Infected implantable devices represent a clinical challenge, because the customary option is to surgically remove the device, and that is associated with substantial cost and morbidity to the patient, along with patient dissatisfaction with the physician. Although prophylactic systemic antibiotics and sterile technique are the mainstay of prevention of surgical site infection (SSI) after implant, the incidence of SSI remains relatively high. Although some surgeons add local antibiotic at implant site during surgery, there is no scientific research to demonstrate if there is a benefit. ⋯ This study suggests that local vancomycin should be added to systemic vancomycin to reduce SSI with cardiac pacemaker, defibrillator, implantable pulse generator of neurostimulator, or intrathecal pump implants.
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Critical care medicine · Oct 2018
Survival of Patients With Vancomycin-Resistant Enterococcus faecium Bacteremia Treated With Conventional or High Doses of Daptomycin or Linezolid Is Associated With the Rate of Bacterial Clearance.
Vancomycin-resistant enterococci are important pathogens for healthcare-associated infections. Although linezolid is bacteriostatic and daptomycin is rapidly bactericidal against vancomycin-resistant enterococci in vitro, it is not clear whether they differ in their effect on bacterial clearance in patients with vancomycin-resistant enterococci bloodstream infections. ⋯ We found that survivors of vancomycin-resistant enterococci bloodstream infection had a significantly more rapid early bacterial clearance by quantitative polymerase chain reaction than nonsurvivors. High-dose daptomycin and linezolid were associated with more rapid bacterial clearance than conventional dose daptomycin. These results support recommendations that conventional dose daptomycin not be used for the treatment of patients with vancomycin-resistant enterococci bloodstream infection.
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Surgical-site infections (SSIs) are an important cause of morbidity and mortality in neurosurgical patients. Topical antibiotics are one potential method to reduce the incidence of these infections. ⋯ Topical vancomycin is a safe, effective, and cost-saving measure to prevent SSIs following craniotomy. These results have broad implications for standard of care in craniotomy.