Evaluation of vancomycin use in universityaffiliated hospitals in southern khorasan province (east iran) based on hicpac guidelines

Mahi-Birjand, M. and Ziaee, M. and Bijari, B. and Khalvati, R. and Abedini, M. R. and Mousavi, H. G. and Ziaee, A. (2019) Evaluation of vancomycin use in universityaffiliated hospitals in southern khorasan province (east iran) based on hicpac guidelines. Drug, Healthcare and Patient Safety, 11. pp. 29-35.

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Abstract

Background: Vancomycin resistance has raised concerns about its effectiveness prospect in the treatment of patients with Gram-positive infections. The Healthcare Infection Control Practices Advisory Committee (HICPAC) has recently established guidelines to delineate improper use of vancomycin. In this light, we sought out to determine the appropriateness of vancomycin prescription using the HICPAC guidelines. Setting: The study was carried out in two university-affiliated hospitals, Valiasr and Imam Reza, with 297 and 234 beds, respectively, from May 2012 to May 2013. Methods: This retrospective study evaluated the vancomycin prescription and usage in the hospitals. Total vancomycin use was determined and expressed as vancomycin courses per 298 admitted patients. The patient information was collected on a data collection sheet as follows: demographic variables, etiology and localization of infection, microbiological data, duration of vancomycin treatment, reasons for vancomycin prescription, prescribed antibiotic dosing, and patient regimen. Results: The average age of the patients and vancomycin treatment duration were 55.965 years and 10.5 days, respectively. Septicemia (15.7) was the most common cause of vancomycin administration. Vancomycin use was documented to be appropriate and inappropriate in 236 (89.4) and 28 (10.6) patients, respectively. No statistically significant differences were found among the wards and hospitals (P values =0.66 and 0.54, respectively) in terms of appropriateness of vancomycin use based on the HICPAC criteria. In addition, 29.21 and 62 of all patients exhibited complete and partial recovery, respectively. We found that 90 of the cases showed compliance with the HICPAC recommendations. Conclusion: Comprehensive programs are required to improve the vancomycin use in the hospitals. Vancomycin use should be monitored due to its large-scale empiric use. The rate of improper use of vancomycin in the infection and intensive care unit services may be high, and pharmacists must take appropriate action to optimize the use of the drug. © 2019 Mahi-Birjand et al.

Item Type: Article
Additional Information: Export Date: 16 February 2020 Correspondence Address: Ziaee, M.; Infectious Disease Research Center, Birjand University of Medical Sciences, Ayatollah Ghaffari Street, Post Box: 397, Iran; email: Dr.m.ziaee@gmail.com
Uncontrolled Keywords: Anti-bacterial agents Drug utilization University hospitals Vancomycin adult antibiotic therapy Article body weight controlled study creatinine clearance demography descriptive research documentation human intensive care unit Iran major clinical study practice guideline prescription treatment duration
Subjects: QZ pathology-neoplasms-Genetics
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib1 lib1
Date Deposited: 21 Jun 2020 07:34
Last Modified: 21 Jun 2020 07:34
URI: http://eprints.mums.ac.ir/id/eprint/18482

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