Abstract

We undertook a prospective cohort study to evaluate the role of a multifaceted infection control policy including the use of a ‘vancomycin order form,’ in decreasing the transmission of vancomycin-resistant enterococci (VRE). In January 1997, a multifaceted infection-control policy was implemented amongst patients admitted to the M. D. Anderson Cancer Center in whom neutropenic fever developed or who were found to be colonized or infected with VRE. As part of this programme, we initiated the use of a vancomycin order form to reduce the use of empirical vancomycin. The total incidence of VRE infections declined from 0.437/1000 patient days in 1996–97 to 0.229/1000 patient days in 1998–99 (P=0.008). The VRE bloodstream infections declined from 0.338/1000 patient days in 1996–97 to 0.181/1000 patient days in 1998–99 (P=0.027). Empiric vancomycin use decreased from 416g/1000 patient days in 1996–97 to 208g/1000 patient days in 1998–99 (P<0.001), resulting in a decreased vancomycin cost from $2561/1000 patient days in 1996–97 to $1195/1000 patient days in 1997–98 (P<0.001). We conclude that a multifaceted infection control policy incorporating the use of a vancomycin order form can effectively decrease the use of empirical vancomycin and can play a role in limiting the spread of VRE in an endemic setting.

Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call