Decreasing Empiric Use of Vancomycin in Late Onset Sepsis: Adherence to Guidelines and Quality Improvement

Background Neonatal late onset sepsis (LOS) remains an important cause of morbidity and mortality in the neonatal intensive care unit (NICU), with coagulase-negative staphylococci as the leading cause of infection. Vancomycin has historically been the drug of choice for staphylococcal infections and is now widely used for empiric management of LOS despite the paucity of data on optimal dosing, efficacy and safety. Its overuse and misuse has led to the emergence of resistant bacterial strains, higher rates of acute kidney injury and rising healthcare costs, and thus represents a crucial area of improvement in the NICU. Objective We aimed to …