Am J Perinatol 2015; 32(06): 565-570
DOI: 10.1055/s-0034-1543955
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Rifampin Use and Safety in Hospitalized Infants

Christopher J. Arnold
1   Duke Clinical Research Institute, Durham, North Carolina
2   Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina
,
Jessica Ericson
1   Duke Clinical Research Institute, Durham, North Carolina
3   Department of Pediatrics, Duke University, Durham, North Carolina
,
Jordan Kohman
1   Duke Clinical Research Institute, Durham, North Carolina
,
Kaitlyn L. Corey
1   Duke Clinical Research Institute, Durham, North Carolina
,
Morgan Oh
1   Duke Clinical Research Institute, Durham, North Carolina
,
Janet Onabanjo
1   Duke Clinical Research Institute, Durham, North Carolina
,
Christoph P. Hornik
1   Duke Clinical Research Institute, Durham, North Carolina
3   Department of Pediatrics, Duke University, Durham, North Carolina
,
Reese H. Clark
4   Pediatrix Medical Group, Sunrise, Florida
,
Daniel K. Benjamin Jr.
1   Duke Clinical Research Institute, Durham, North Carolina
3   Department of Pediatrics, Duke University, Durham, North Carolina
,
P. Brian Smith
1   Duke Clinical Research Institute, Durham, North Carolina
3   Department of Pediatrics, Duke University, Durham, North Carolina
,
Vivian H. Chu
1   Duke Clinical Research Institute, Durham, North Carolina
2   Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina
,
on behalf of the Best Pharmaceuticals for Children Act–Pediatric Trials Network Administrative Core Committee › Author Affiliations
Further Information

Publication History

04 September 2014

18 November 2014

Publication Date:
16 January 2015 (online)

Abstract

Objective This study aims to examine the use and safety of rifampin in the hospitalized infants.

Study Design Observational study of clinical and laboratory adverse events among infants exposed to rifampin from 348 neonatal intensive care units managed by the Pediatrix Medical Group between 1997 and 2012.

Result Overall, 2,500 infants received 4,279 courses of rifampin; mean gestational age was 27 weeks (5th, 95th percentile; 23, 36) and mean birth weight was 1,125 g (515; 2,830). Thrombocytopenia (121/1,000 infant days) and conjugated hyperbilirubinemia (25/1,000 infant days) were the most common laboratory adverse events. The most common clinical adverse events were medical necrotizing enterocolitis (64/2,500 infants, 3%) and seizure (60/2,500 infants, 2%).

Conclusion The overall incidence of adverse events among infants receiving rifampin appears low; however, additional studies to further evaluate safety and dosing of rifampin in this population are needed.

* Katherine Y. Berezny, Duke Clinical Research Institute, Durham, NC; Edmund Capparelli, University of California–San Diego, San Diego, CA; Michael Cohen-Wolkowiez, Duke Clinical Research Institute, Durham, NC; Gregory L. Kearns, Children's Mercy Hospital, Kansas City, MO; Matthew Laughon, University of North Carolina at Chapel Hill, Chapel Hill, NC; Andre Muelenaer, Virginia Tech Carilion School of Medicine, Roanoke, VA; T. Michael O'Shea, Wake Forest Baptist Medical Center, Winston Salem, NC; Ian M. Paul, Penn State College of Medicine, Hershey, PA; John van den Anker, George Washington University School of Medicine and Health, Washington, DC; Kelly Wade, Children's Hospital of Philadelphia, Philadelphia, PA; Thomas J. Walsh, Weill Cornell Medical College of Cornell University, New York, NY.


 
  • References

  • 1 Alsayyed B. Rifampin. Pediatr Rev 2004; 25: 216-217
  • 2 Shama A, Patole SK, Whitehall JS. Intravenous rifampicin in neonates with persistent staphylococcal bacteraemia. Acta Paediatr 2002; 91 (6) 670-673
  • 3 Soraisham AS, Al-Hindi MY. Intravenous rifampicin for persistent staphylococcal bacteremia in premature infants. Pediatr Int 2008; 50 (1) 124-126
  • 4 van der Lugt NM, Steggerda SJ, Walther FJ. Use of rifampin in persistent coagulase negative staphylococcal bacteremia in neonates. BMC Pediatr 2010; 10: 84
  • 5 Tan TQ, Mason Jr EO, Ou CN, Kaplan SL. Use of intravenous rifampin in neonates with persistent staphylococcal bacteremia. Antimicrob Agents Chemother 1993; 37 (11) 2401-2406
  • 6 Bayston R. Hydrocephalus shunt infections. J Antimicrob Chemother 1994; 34 (Suppl A): 75-84
  • 7 Forward KR, Fewer HD, Stiver HG. Cerebrospinal fluid shunt infections. A review of 35 infections in 32 patients. J Neurosurg 1983; 59 (3) 389-394
  • 8 Gombert ME, Landesman SH, Corrado ML, Stein SC, Melvin ET, Cummings M. Vancomycin and rifampin therapy for Staphylococcus epidermidis meningitis associated with CSF shunts: report of three cases. J Neurosurg 1981; 55 (4) 633-636
  • 9 McGirt MJ, Zaas A, Fuchs HE, George TM, Kaye K, Sexton DJ. Risk factors for pediatric ventriculoperitoneal shunt infection and predictors of infectious pathogens. Clin Infect Dis 2003; 36 (7) 858-862
  • 10 Chapman RL, Faix RG. Persistent bacteremia and outcome in late onset infection among infants in a neonatal intensive care unit. Pediatr Infect Dis J 2003; 22 (1) 17-21
  • 11 O'Brien RJ, Long MW, Cross FS, Lyle MA, Snider Jr DE. Hepatotoxicity from isoniazid and rifampin among children treated for tuberculosis. Pediatrics 1983; 72 (4) 491-499
  • 12 Rifadin IV. Rifampin for injection [package insert]. Bridgewater, NJ: Sanofi-Aventis US LLC; 2013
  • 13 Bliziotis IA, Ntziora F, Lawrence KR, Falagas ME. Rifampin as adjuvant treatment of Gram-positive bacterial infections: a systematic review of comparative clinical trials. Eur J Clin Microbiol Infect Dis 2007; 26 (12) 849-856
  • 14 Fortunov RM, Hulten KG, Hammerman WA, Mason Jr EO, Kaplan SL. Community-acquired Staphylococcus aureus infections in term and near-term previously healthy neonates. Pediatrics 2006; 118 (3) 874-881
  • 15 Gerber JS, Coffin SE, Smathers SA, Zaoutis TE. Trends in the incidence of methicillin-resistant Staphylococcus aureus infection in children's hospitals in the United States. Clin Infect Dis 2009; 49 (1) 65-71
  • 16 Borghesi A, Stronati M. Strategies for the prevention of hospital-acquired infections in the neonatal intensive care unit. J Hosp Infect 2008; 68 (4) 293-300
  • 17 Li S, Bizzarro MJ. Prevention of central line associated bloodstream infections in critical care units. Curr Opin Pediatr 2011; 23 (1) 85-90
  • 18 Schulman J, Stricof R, Stevens TP , et al; New York State Regional Perinatal Care Centers. Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists. Pediatrics 2011; 127 (3) 436-444
  • 19 Moyer V, Freese DK, Whitington PF , et al; North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Guideline for the evaluation of cholestatic jaundice in infants: recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2004; 39 (2) 115-128
  • 20 Grosset J, Leventis S. Adverse effects of rifampin. Rev Infect Dis 1983; 5 (Suppl. 03) S440-S450
  • 21 Lee CH, Lee CJ. Thrombocytopenia—a rare but potentially serious side effect of initial daily and interrupted use of rifampicin. Chest 1989; 96 (1) 202-203
  • 22 Mathur NB, Agarwal HS, Maria A. Acute renal failure in neonatal sepsis. Indian J Pediatr 2006; 73 (6) 499-502
  • 23 Agras PI, Tarcan A, Baskin E, Cengiz N, Gürakan B, Saatci U. Acute renal failure in the neonatal period. Ren Fail 2004; 26 (3) 305-309
  • 24 Stapleton FB, Jones DP, Green RS. Acute renal failure in neonates: incidence, etiology and outcome. Pediatr Nephrol 1987; 1 (3) 314-320