Factors associated with mortality of neonates with neonatal sepsis under antibiotic therapy with vancomycin

Abstract

Objective: To evaluate clinical and laboratory alterations associated with death in neonatal patients using vancomycin. Methods: This is a retrospective cohort study in volving analysis of serum vancomycin monitoring in 57 neonatal patients admitted to a reference maternity hospital in the state of Ceará, from January to July 2021. Data were collected on clinical parameters, laboratory tests, and death out come of patients. Data were obtained from physical and electronic medical records. Results: Of the 57 newborns (NBs), 32 (56%) were female and 25 (44%) were male. Regarding the clinical outcome, it was observed that 33% of the neonates evolved to death. Patients with vancomycinemia levels above the therapeutic window presented increased serum creatinine levels (p = 0.0152). A significant correlation of moderate strength was observed between serum creatinine and vancomycin concentrations (r = 0.5822; p = 0.0007). In this sense, the ROC curve showed that the analysis of serum creatinine helps in predicting altered levels of vancomycinemia (AUC = 0.7813; p < 0.05). Conclusion: It is concluded that the analysis revealed that changes in creatinine levels, associated or not with high vancomycinemia, were predictors of death in the patients studied.