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A descriptive study of vancomycin use at Red Cross War Memorial Children's Hospital, Cape Town

Leonore Greybe1, Brian S Eley1, Hafsah D Tootla2

  • 1Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Southern African Journal of Infectious Diseases
|December 7, 2023
PubMed

Insights

Paediatric vancomycin prescribing in South Africa showed dosing errors, prolonged empiric use, and inadequate monitoring. Improved practices are crucial for preserving vancomycin effectiveness in children.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Pharmacology

Background:

  • Antimicrobial stewardship principles are essential for guiding antimicrobial use, including vancomycin.
  • Paediatric vancomycin prescribing practices in South Africa have not been previously evaluated.

Purpose of the Study:

  • To document the use, prescribing practices, and monitoring of intravenous vancomycin in children.
  • To analyze the spectrum of bacteria isolated from children receiving intravenous vancomycin.

Main Methods:

  • A retrospective audit of intravenous vancomycin use in children at Red Cross War Memorial Children's Hospital (RCWMCH) during 2019.
  • Inclusion of 158 vancomycin prescription episodes for 143 children.

Main Results:

  • Overall vancomycin usage was 63 days of therapy per 1000 patient days.
  • Median starting dose was 15 mg/kg/dose, with 80% prescribed empirically.
  • Vancomycin trough concentrations were monitored in 66% of eligible episodes, with only 25% drawn before the fourth dose.

Conclusions:

  • Dosing errors, prolonged empiric vancomycin treatment, and inadequate monitoring were identified issues.
  • Opportunities exist for improving vancomycin prescribing and monitoring in paediatric patients.
  • Enhanced practices can help preserve vancomycin's efficacy.
Abstract

Keywords:
AMSTDMantimicrobial stewardshipauditpaediatricstherapeutic drug monitoringvancomycin

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