Abstract
Background: Vancomycin is an antibiotic of growing importance in the treatment of hospital-acquired infections; with a particular emphasis on its value in the fight against Methicillin-resistant Staphylococcus aureus. Increasing reports of Vancomycin resistance have raised concerns about the effectiveness of this drug. Drug utilization evaluation has an important role in controlling rational use of antibiotics to prevent the emergence of resistance. Methods: We conducted a retrospective 6-months study at Jafar Ibn Auf pediatric hospital. Data including patient's demographics, diagnosis, Dosage regimen, and treatment duration were reviewed. The concordance of practice with the Hospital Infection Control Practices Advisory Committee (HICPAC) guidelines and principles of antibiotic therapy was assessed. Results: 127 medical records were reviewed in this study. Sepsis (29%) and Pneumonia (19.6%) were the most common indications. Culture test was requested in 20.5% of patients. Monitoring of serum creatinine was carried in 81.1% of patients. Based on HICPAC guidelines vancomycin was administered appropriately in 67.7% percent of cases. Considering the infusion rate, most of patients with specific order were received vancomycin in 1 hour. Conclusions: The results showed that vancomycin was used empirically without subsequent adjustment of the antimicrobial agent according to culture and sensitivity data and lack of paying enough attention to the infusion rate and serum creatinine monitoring.
Highlights
The majority of admitted inpatients are given antimicrobials as therapy or prophylaxis during their hospitalization
The increase in vancomycin-resistant enterococci (VRE) has led to the development of recommendations for the use of vancomycin by the Hospital Infection Control Practices Advisory Committee (HICPAC)[10], a part of the Centers for Disease Control and Prevention (CDC), published in 1995
Since we did not have any data regarding how rationally vancomycin is being prescribed in Jafar Ibn Auf Pediatric Hospital, we conducted this Drug utilization evaluation (DUE) study to determine the rate of rational use of vancomycin according to the standard guidelines
Summary
The majority of admitted inpatients are given antimicrobials as therapy or prophylaxis during their hospitalization. Cases of MRSA have increased in the US from 35.9% in 1992 to 64.4% in 2003, mainly due to inappropriate prescribing of broad spectrum antibiotics[8]. The increase in VRE has led to the development of recommendations for the use of vancomycin by the Hospital Infection Control Practices Advisory Committee (HICPAC)[10], a part of the Centers for Disease Control and Prevention (CDC), published in 1995. They indicate what constitutes appropriate and inappropriate usage of vancomycin, and advises physicians to use the guidelines to decrease the emergence of vancomycin-resistant strains[11]. Since we did not have any data regarding how rationally vancomycin is being prescribed in Jafar Ibn Auf Pediatric Hospital, we conducted this DUE study to determine the rate of rational use of vancomycin according to the standard guidelines
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