Vancomycin use in hospitalized pediatric patients

Area of Science:

• Pediatric Infectious Diseases
• Antimicrobial Stewardship
• Hospital Epidemiology

Background:

• Vancomycin is a critical antibiotic for treating serious infections, but its use requires careful management to prevent resistance.
• Optimizing vancomycin prescribing practices in pediatric settings is essential for effective treatment and antimicrobial stewardship.

Purpose of the Study:

• To evaluate vancomycin utilization patterns in children's hospitals.
• To identify risk factors associated with vancomycin use and duration of therapy.
• To inform recommendations for optimizing vancomycin prescribing in pediatric patients.

Main Methods:

• Two surveys were administered to hospitals within the Pediatric Prevention Network.
• Survey I assessed hospital vancomycin control programs and policies.
• Survey II prospectively reviewed 416 vancomycin courses in 22 hospitals.

Main Results:

• Most hospitals (85%) had policies restricting vancomycin use.
• Vancomycin was primarily prescribed for neonatal sepsis, fever/neutropenia, and positive blood cultures (82%).
• Vascular catheters (77%) were the predominant risk factor for initiation, with limited laboratory confirmation of resistant organisms (7%).

Conclusions:

• Vancomycin initiation in children's hospitals often involves patients with vascular catheters and compromised immunity.
• Targeted interventions should focus on intensivists, neonatologists, and hematologists to modify empiric use.
• Reducing prophylaxis duration and optimizing therapy based on lab results can decrease vancomycin exposure.