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Vancomycin in Oregon: who's using it and why.
P R Cieslak1, L J Strausbaugh, D W Fleming
1Division of Applied Public Health Training, State Branch, Portland, Oregon, USA.
Infection Control and Hospital Epidemiology
|August 31, 1999
Summary
Many vancomycin orders were inappropriate, indicating a need for hospital pharmacy restrictions rather than just education. This study analyzed vancomycin use across Oregon hospitals.
Area of Science:
- Pharmacology
- Infectious Diseases
- Health Services Research
Background:
- Vancomycin is a critical antibiotic for treating serious gram-positive infections.
- Appropriate vancomycin use is essential to combat antimicrobial resistance and improve patient outcomes.
Purpose of the Study:
- To assess the appropriateness of vancomycin orders in Oregon hospitals based on national guidelines.
- To identify specific areas for targeted educational interventions regarding vancomycin prescribing.
Main Methods:
- A population-based study was conducted across nonpsychiatric hospitals in Oregon.
- Data collection involved surveying pharmacists, prospective flagging of vancomycin orders, and chart reviews.
- The study analyzed 293 vancomycin orders over a 3-week period.
Main Results:
- Only 60% of vancomycin orders were deemed appropriate according to national guidelines.
- Appropriateness varied by indication, with prophylaxis at 57%, empirical treatment at 56%, and documented infection at 65%.
- Inappropriate vancomycin use was widespread across various medical specialties and hospital sizes.
Conclusions:
- Inappropriate vancomycin prescribing is a significant issue in diverse clinical settings and across different medical specialties.
- Educational strategies alone may be insufficient; hospital pharmacy restrictions on vancomycin orders might be necessary.
- The findings suggest a need for broader interventions to optimize vancomycin utilization.