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A retrospective drug utilization evaluation of vancomycin usage in paediatric patients

W C Hing1, S J Bek, R T P Lin

  • 1Department of Pharmacy, KK Women's and Children's Hospital, Singapore.

Journal of Clinical Pharmacy and Therapeutics
|July 24, 2004
PubMed

Insights

This study assessed vancomycin use in children, finding dosing generally appropriate but highlighting issues with monitoring serum levels and indications. Optimizing vancomycin prescribing practices is crucial for patient safety and effective treatment.

Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Pediatric Infectious Diseases

Background:

  • Vancomycin is a critical antibiotic for treating serious Gram-positive bacterial infections in pediatric patients.
  • Appropriate vancomycin usage is essential to ensure efficacy and minimize the risk of adverse drug reactions (ADRs) and antimicrobial resistance.
  • Evaluating prescribing practices helps identify areas for improvement in pediatric vancomycin therapy.

Purpose of the Study:

  • To assess the appropriateness of vancomycin prescribing in pediatric patients at a major children's hospital.
  • To identify potential issues in vancomycin usage patterns that may require intervention.
  • To optimize vancomycin utilization in pediatric care.

Main Methods:

  • Retrospective drug utilization evaluation of pediatric patients receiving intravenous vancomycin over a one-year period.
  • Analysis of vancomycin indication consistency with guidelines, dosing, microbiological data, serum drug level monitoring, renal function, clinical outcomes, and ADRs.
  • Review of 96 patient cases for comprehensive assessment of vancomycin prescribing practices.

Main Results:

  • 64.6% of vancomycin courses had appropriate indications, and 89.6% used consistent dosing regimens.
  • Therapeutic vancomycin serum levels were frequently outside the recommended range (46/56 cases with paired levels).
  • Adverse drug reactions (ADRs) were documented in 19.8% of cases, with 60.4% receiving concurrent nephrotoxic drugs.

Conclusions:

  • While vancomycin dosing regimens were largely guideline-consistent, significant issues were noted in monitoring serum drug levels.
  • Inappropriate indications and poor recording of administration details were also identified as problems.
  • Findings underscore the need for strategies to optimize vancomycin prescribing and monitoring in pediatric patients.
Abstract

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