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.

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.

• Authors: Jean G Dib, Jaffar A Al-Tawfiq, Saud Al Abdulmohsin, Khurram Mohammed, Phyllis D Jenden
• Journal: Journal of infection and public health (J Infect Public Health) Vol. 2 Issue 3 Pg. 141-6 ( 2009) ISSN: 1876-035X [Electronic] England
• PMID: 20701874 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Vancomycin

Topics

• Adult
• Aged
• Aged, 80 and over
• Anti-Bacterial Agents (blood, 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, therapeutic use)