Vascular Access Conversation - IVUPDATE Podcast from IVTEAM

"The results did not show a statistically significant improvement in the incidence of sepsis in neonates who received prophylactic vancomycin prior to PICC discontinuation" Baker et al (2022).
Prophylactic vancomycin administration prior to PICC removal

Abstract:

Objective: To evaluate the effect of a single dose of prophylactic vancomycin prior to the removal of a peripherally inserted central catheter (PICC) in decreasing sepsis evaluations, positive cultures, and antibiotic usage in neonates.

Methods: A retrospective review was conducted from December 1, 2015, through November 30, 2019, to evaluate outcomes of sepsis evaluations, positive cultures, and antibiotic usage in neonates not receiving prophylactic vancomycin prior to the discontinuation of a PICC as compared with those receiving prophylaxis vancomycin in a neonatal intensive care unit (NICU).

Results: Of the 138 neonates enrolled in the study, 82 did not receive vancomycin prophylaxis (Cohort 1), and 56 did (Cohort 2). Both cohorts were similar in sex distribution, gestational age, and PICC days. The frequency of sepsis evaluations, positive cultures, and the need for antibiotics was not found to be significant (p = 0.404, 0.703, 0.808) (Table 2).iv7

Conclusions: The results did not show a statistically significant improvement in the incidence of sepsis in neonates who received prophylactic vancomycin prior to PICC discontinuation. However, there were lower percentages of sepsis evaluations, positive cultures, and antibiotics administered in the Cohort 2 patients. Although the advantage of implementing this antibiotic policy is uncertain based on this study, further research across multiple centers including a larger number of subjects may provide more conclusive results.

Reference:

Baker M, Bhattarai B, Johnson PJ, Wade C, Micetic B, Mody K. The Effect of a Single Dose of Prophylactic Vancomycin Prior to Peripherally Inserted Central Catheter Removal on Sepsis. J Pediatr Pharmacol Ther. 2022;27(8):715-719. doi: 10.5863/1551-6776-27.8.715. Epub 2022 Nov 17. PMID: 36415766; PMCID: PMC9674359.