{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T20:18:20Z","timestamp":1767125900265,"version":"3.48.0"},"reference-count":20,"publisher":"The Pediatric Pharmacy Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12]]},"abstract":"\n OBJECTIVE<\/jats:title>\n To compare clinical outcomes in neonates receiving empiric vancomycin or nafcillin containing regimens for neonatal late onset sepsis (nLOS).<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n 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\n Staphylococcus aureus<\/jats:italic>\n colonization, deep-seated infection, and mortality.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Use of nafcillin as the Gram-positive empiric treatment agent did not result in increased clinical worsening compared to vancomycin at our institution.<\/jats:p>\n <\/jats:sec>","DOI":"10.5863\/jppt-24-00143","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T15:57:31Z","timestamp":1765814251000},"page":"788-792","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Empiric Nafcillin Versus Vancomycin for Suspected Late Onset Sepsis in the Neonatal Intensive Care Unit"],"prefix":"10.5863","volume":"30","author":[{"given":"Sarah","family":"Hanson","sequence":"first","affiliation":[{"name":"Atrium Health Levine Cancer Institute (SH), Charlotte, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Barnes","sequence":"additional","affiliation":[{"name":"Atrium Health Levine Children\u2019s Hospital (JB, JJ, LM), Charlotte, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanne B.","family":"Forrester","sequence":"additional","affiliation":[{"name":"Clinical Education Alliance (JF), US Medical Affairs, Merck Research Laboratories (RP)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James E.","family":"Jones","sequence":"additional","affiliation":[{"name":"Atrium Health Levine Children\u2019s Hospital (JB, JJ, LM), Charlotte, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee E.","family":"Morris","sequence":"additional","affiliation":[{"name":"Atrium Health Levine Children\u2019s Hospital (JB, JJ, LM), Charlotte, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rupal M.","family":"Patel","sequence":"additional","affiliation":[{"name":"Clinical Education Alliance (JF), US Medical Affairs, Merck Research Laboratories (RP)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"6","key":"JPPT-24-00143-b01","series-title":"J Pediatr","first-page":"1120","article-title":"Late-onset sepsis in very low birth weight infants from singleton and multiple-gestation births","volume":"162","author":"Boghossian","year":"2013","unstructured":"Boghossian NS, Page GP, Bell EF, et al; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Late-onset sepsis in very low birth weight infants from singleton and multiple-gestation births. J Pediatr. 2013;162(6):1120\u20131124, 1124.e1."},{"issue":"3","key":"JPPT-24-00143-b02","series-title":"Pediatrics","first-page":"E29","article-title":"Clinical outcome of cephalothin versus vancomycin therapy in the treatment of coagulase-negative staphylococcal septicemia in neonates: relation to methicillin resistance and mec A gene carriage of blood isolates","volume":"103","author":"Krediet","year":"1999","unstructured":"Krediet TG, Jones ME, Gerards LJ, Fleer A. Clinical outcome of cephalothin versus vancomycin therapy in the treatment of coagulase-negative staphylococcal septicemia in neonates: relation to methicillin resistance and mec A gene carriage of blood isolates. Pediatrics. 1999;103(3):E29."},{"key":"JPPT-24-00143-b03","series-title":"BMC Pediatr","first-page":"49","article-title":"Cloxacillin versus vancomycin for presumed late-onset sepsis in the neonatal intensive care unit and the impact upon outcome of coagulase negative staphylococcal bacteremia: a retrospective cohort study","volume":"5","author":"Lawrence","year":"2005","unstructured":"Lawrence SL, Roth V, Slinger R, et al. Cloxacillin versus vancomycin for presumed late-onset sepsis in the neonatal intensive care unit and the impact upon outcome of coagulase negative staphylococcal bacteremia: a retrospective cohort study. BMC Pediatr. 2005;5:49."},{"issue":"4","key":"JPPT-24-00143-b04","series-title":"Pediatr Infect Dis J","first-page":"273","article-title":"Effectiveness of a guideline to reduce vancomycin use in the neonatal intensive care unit","volume":"30","author":"Chiu","year":"2011","unstructured":"Chiu C-H, Michelow IC, Cronin J, et al. Effectiveness of a guideline to reduce vancomycin use in the neonatal intensive care unit. Pediatr Infect Dis J. 2011;30(4):273\u2013278."},{"issue":"11","key":"JPPT-24-00143-b05","series-title":"Am J Infect Control","first-page":"1255","article-title":"Decreasing vancomycin utilization in a neonatal intensive care unit","volume":"43","author":"Holzmann-Pazgal","year":"2015","unstructured":"Holzmann-Pazgal G, Khan AM, Northrup TF, et al. Decreasing vancomycin utilization in a neonatal intensive care unit. Am J Infect Control. 2015;43(11):1255\u20131257."},{"key":"JPPT-24-00143-b06","series-title":"Pediatr Infect Dis J","first-page":"e49","article-title":"Experience with a vancomycin-sparing empiric antibiotic guideline for late-onset sepsis in a level-4 neonatal intensive care unit","volume":"43","author":"Dumont","year":"2024","unstructured":"Dumont O, Iocono D, Jacob A, et al. Experience with a vancomycin-sparing empiric antibiotic guideline for late-onset sepsis in a level-4 neonatal intensive care unit. Pediatr Infect Dis J. 2024;43:e49\u2013e51."},{"issue":"5","key":"JPPT-24-00143-b07","series-title":"Pediatrics","first-page":"e2021052360","article-title":"Safety and efficacy of nafcillin for empiric therapy of late-onset sepsis in the NICU","volume":"149","author":"Magers","year":"2022","unstructured":"Magers J, Prusakov P, Speaks S, Conroy S, Sanchez PJ. Safety and efficacy of nafcillin for empiric therapy of late-onset sepsis in the NICU. Pediatrics. 2022;149(5):e2021052360."},{"issue":"6","key":"JPPT-24-00143-b08","series-title":"Pediatrics","first-page":"1387","article-title":"Fulminant late-onset sepsis in a neonatal intensive care unit, 1988\u20131997, and the impact of avoiding empiric vancomycin therapy","volume":"106","author":"Karlowicz","year":"2000","unstructured":"Karlowicz MG, Buescher ES, Surka AE. Fulminant late-onset sepsis in a neonatal intensive care unit, 1988\u20131997, and the impact of avoiding empiric vancomycin therapy. Pediatrics. 2000;106(6):1387\u20131390."},{"key":"JPPT-24-00143-b09","series-title":"Pediatr Infect Dis J","first-page":"371","article-title":"No survival benefit with empirical vancomycin therapy for coagulase-negative staphylococcal bloodstream infections in infants","volume":"34","author":"Ericson","year":"2015","unstructured":"Ericson JE, Thaden J, Cross HR, et al. No survival benefit with empirical vancomycin therapy for coagulase-negative staphylococcal bloodstream infections in infants. 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