Improvement in vancomycin utilization in adults in a Saudi Arabian Medical Center using the Hospital Infection Control Practices Advisory Committee guidelines and simple educational activity

J Infect Public Health. 2009;2(3):141-6. doi: 10.1016/j.jiph.2009.07.002. Epub 2009 Sep 18.

Abstract

Objective: To evaluate vancomycin utilization according to the adapted criteria of the Centers for Disease Control and Prevention (CDC) with a report of the effect of education program on the utilization.

Method: We evaluated the utilization of vancomycin over a 3-month period pre- and post-intervention using educational activity.

Results: In the pre-intervention period, of the 74 adult patients vancomycin was prescribed for specific treatment in 66% (n=49), empirical therapy in 26% (n=19) and as a prophylaxis in 8% (n=6). Vancomycin utilization was considered appropriate based on the CDC recommendations in 48 (65%) patients. Forty-seven (64%) patients received an appropriate dose regimen based on weight, age and creatinine clearance. Only 31% (n=23) of patients had both peak and trough levels taken around the third dose. In the post-intervention period, vancomycin was used as specific therapy in 41% (n=14) and empirically in 59% (n=20). Compliance with guidelines for empirical use of vancomycin improved from 21% in the pre-intervention phase to 85% after the intervention (P=.0001). In addition, compliance with vancomycin use in specific therapy was 100% compared to 82%. Compliance rate with vancomycin trough level monitoring increased from 35% in the pre-intervention period to 67.7% in the post-intervention period (P=0.0002).

Conclusion: In conclusion, in addition to the utilization of CDC based criteria for vancomycin, we had shown that patient's chart review by a clinical pharmacists with a feed back to the physicians when guidelines were not met coupled with and educational efforts are effective methods to decrease inappropriate vancomycin usage.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / blood
  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis / statistics & numerical data*
  • Centers for Disease Control and Prevention, U.S.
  • Cross Infection / prevention & control*
  • Drug Utilization
  • Education, Medical, Continuing
  • Female
  • Guideline Adherence
  • Humans
  • Infection Control / methods*
  • Male
  • Methicillin-Resistant Staphylococcus aureus
  • Middle Aged
  • Practice Guidelines as Topic
  • Saudi Arabia
  • Staphylococcal Infections / prevention & control
  • United States
  • Vancomycin / blood
  • Vancomycin / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Vancomycin