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Analysis of vancomycin use and associated risk factors in a university teaching hospital: a prospective cohort study

Moacyr S Junior1, Luci Correa, Alexandre R Marra

  • 1Department of Infectious Disease, Universidade Federal de Sao Paulo, Sao Paulo, Brazil. moacyrjunior8@hotmail.com

BMC Infectious Diseases
|August 7, 2007
PubMed
Abstract

Insights

Vancomycin use was frequently inappropriate, particularly in younger patients, those outside the ICU, and those without neutropenia. Reducing vancomycin exposure is crucial to combat rising resistance and prevent vancomycin-resistant enterococci (VRE).

Area of Science:

  • Infectious Diseases
  • Clinical Pharmacy
  • Antimicrobial Stewardship

Background:

  • Vancomycin use is often inappropriate in hospitals.
  • Emergence of vancomycin-resistant enterococci (VRE) and decreased susceptibility in S. aureus necessitates reduced vancomycin exposure.
  • Analysis of vancomycin usage patterns and risk factors for inappropriate treatment is critical.

Purpose of the Study:

  • To analyze vancomycin utilization in a university hospital.
  • To identify risk factors associated with inappropriate vancomycin prescribing.
  • To assess adherence to Centers for Disease Control and Prevention (CDC) criteria for vancomycin use.

Main Methods:

  • Prospective survey of vancomycin use over a six-month period.
  • Assessment of vancomycin appropriateness at 24 hours and 72 hours of therapy.
  • Statistical analysis to determine risk factors for inappropriate use using odds ratios (OR) and confidence intervals (CI).

Main Results:

  • Vancomycin was inappropriately used in 65.7% of cases at 24 hours and 67% at 72 hours.
  • Inappropriate use was linked to younger age (<60), non-ICU admission, and absence of neutropenia.
  • Patients aged <60 without neutropenia and not in the ICU were at significantly higher risk (ORs ranging from 1.5 to 8.0).

Conclusions:

  • Vancomycin was significantly overused and inappropriately prescribed.
  • Younger patients, non-ICU patients, and those without neutropenia represent key populations at risk for inappropriate vancomycin therapy.
  • Findings underscore the need for enhanced antimicrobial stewardship programs to optimize vancomycin use.

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