ABSTRACT
To evaluate vancomycin utilization according to the adapted criteria of the Centers for Disease Control and Prevention [CDC] with a report of the effect of education program on the utilization. We evaluated the utilization of vancomycin over a 3-month period pre- and post-intervention using educational activity. In the pre-intervention period, of the 74 adult patients vancomycin was prescribed for specific treatment in 66% [n = 49], empirical therapy in 26% [n = 19] and as a prophylaxis in 8% [n = 6]. Vancomycin utilization was considered appropriate based on the CDC recommendations in 48 [65%] patients. Forty-seven [64%] patients received an appropriate dose regimen based on weight, age and creatinine clearance. Only 31% [n = 23] of patients had both peak and trough levels taken around the third dose. In the post-intervention period, vancomycin was used as specific therapy in 41% [n = 14] and empirically in 59% [n = 20]. Compliance with guidelines for empirical use of vancomycin improved from 21% in the pre-intervention phase to 85% after the intervention [P = .0001]. In addition, compliance with vancomycin use in specific therapy was 100% compared to 82%. Compliance rate with vancomycin trough level monitoring increased from 35% in the pre-intervention period to 67.7% in the post-intervention period [P = 0.0002]. In conclusion, in addition to the utilization of CDC based criteria for vancomycin, we had shown that patient's chart review by a clinical pharmacists with a feed back to the physicians when guidelines were not met coupled with and educational efforts are effective methods to decrease inappropriate vancomycin usage