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Epidemiology of vancomycin usage at a children's hospital, 1993 through 1995

R L Sinkowitz1, H Keyserling, T J Walker

  • 1Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.

The Pediatric Infectious Disease Journal
|May 1, 1997
PubMed

Insights

Vancomycin use decreased in children

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Health Informatics

Background:

  • Vancomycin is a critical antibiotic for treating serious Gram-positive bacterial infections.
  • Understanding patterns of vancomycin usage in pediatric populations is essential for effective antimicrobial stewardship.
  • Pharmacy databases offer a valuable resource for analyzing drug utilization trends.

Purpose of the Study:

  • To characterize the epidemiology of vancomycin utilization within a children's hospital setting.
  • To identify patient demographics, service lines, and trends associated with vancomycin use.
  • To provide data for targeted interventions aimed at optimizing antibiotic prescribing.

Main Methods:

  • A retrospective cohort study was conducted at Egleston Children's Hospital.
  • Data on vancomycin charges were extracted from pharmacy records within the hospital's information system.
  • The study period spanned from October 1992 to October 1995, encompassing 3589 patient hospitalizations.

Main Results:

  • Vancomycin was administered in 3589 hospitalizations, with a median of 11 doses per patient.
  • The majority of vancomycin doses (75.7%) were prescribed by hematology, neurosurgery, cardiothoracic surgery, neonatology, and general pediatrics services.
  • Despite a significant decrease in vancomycin doses over the study period (P < 0.001), usage remained substantial, particularly in surgery services.

Conclusions:

  • Pharmacy charge data are effective for monitoring antimicrobial use.
  • While vancomycin use declined, significant prescribing persisted, especially among subspecialty services.
  • Future interventions to reduce vancomycin use should prioritize hematology, neurosurgery, cardiothoracic surgery, neonatology, and general pediatrics.
Abstract

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