Drug utilization evaluation of vancomycin in pediatric department

Background: Increasing reports of Vancomycin resistance have raised concerns about effectiveness of this drug. One of the most important factors of resistance emergence is no adherence of physician to principles of antibiotic therapy. This study is a drug utilization evaluation [DUE] of Vancomycin in pediatric ward to assess appropriateness of drug regimens and to find possible problems in clinical practices that may necessitate reconciliation to improve Vancomycin use

Materials and Methods: This prospective study was done for 1year from October 2014 to September 2015 at Khalij Fars General Hospital in Bandar Abbas. Data including patients' demographics, paraclinic, diagnosis, vancomycin dose, and treatment duration were collected. The concordance of practice with standard guidelines [CDC, ASHP, and IDSA] and principles of antibiotic therapy was assessed. Results were analyzed by SPSS 20

Results: 102 medical records were reviewed in this study. Pneumonia [60=59%] and sepsis [22=21.5%] were the most common diagnosis. Sampling was done in 6% of patients with 2% antibiogram. Vancomycin was administered appropriately in 56.9% percent of patients with no sex difference [PV= 0.55] but age with significant difference [PV= 0.017]. Over use was in a great proportion of patients [36cases=35%] as unnecessary, improper combination and broad spectrum regimen

Conclusion: Vancomycin was overused irrationally in a great proportion of patients. There was no serum level monitoring. Microbial resistance, serum trough level monitoring programs and continuous medical education for physicians can be effective in rational use of antibiotic

sustained virologic response and adverse effects of peg interferon alfa and ribavirin in the treatment of patients with chronic hepatitis c: a study from Iran

Background: Hepatitis C infection is a worldwide problem. In Iran, hepatitis C virus [HCV] infection prevalence is about 1-2%. A combination therapy of pegylated interferon alfa-2a and ribavirin [PEG-IFNalpha/RBV] is a standard treatment, but our aim was to determine the efficacy and safety of dual PEG-IFNalpha/RBV therapy in treating patients infected with HCV in Iranian context

Materials and Methods: This study is a cross sectional conducted among 98 HCV infected patients who were admitted to Labbafinezhad Hospital [Tehran, Iran] for treatment from April 2014 to September 2016. Patients were medicated with Peg Interferon Alfa [INFalpha] and Ribavirin [RBV]. Lab tests were monitored through the study and dose modification was done. We also assessed treatment responses at the defined time points. The incidences of adverse events were determined either. We investigated independent predictors of sustained virologic response [SVR] in the participants. Finally, data were gathered and statistical analysis was completed

Results: Eighty-eight percent of patients were male and 11.2% were female. Mean age was 43.44 years. Patients were mostly male, single, with nongovernmental business and low level of education. Risk factors were known to be addiction with non-injectable substances and phlebotomy. Myalgia, fatigue and malaises were the most common complications and suicide intention was the least one. SVR was estimated 76.7%. AST and ALT were significantly reduced in treatment period

Conclusion: Peg INFa and RBV are effective in treating HCV infection

Comparison of mono and biphasic culture media in isolating bacteria from blood and evaluation Bu-Ali hospital lab quality

Blood Culture is an important diagnostic method in infectious diseases and has positive results in 30%- 50% and even to 80% of cases due to sample volume. In Bu-Ali Hospital, Tehran, it decreases to 2-3%. In this survey, quality of hospital lab and difference between Mono and Biphasic culture media in isolating bacteria from blood of patients suggestive of sepsis were evaluated.106 [48 F + 58 M] newly admitted patients with impression of sepsis as SIRS [Systemic Inflammatory Response Syndrome] [36[degree sign]C >OT>38.3[degree sign]C , tachycardia more than 100/min, leukocytosis with shift to left or leucopenia] with infectious source were sampled for culture [5ml blood 3 times in 1 Biphasic and 2 Monophasic media] in the infectious ward. One Monophasic Media in hospital lab and the two other [1 Monophasic + 1 Biphasic Media] in Reference Laboratory of Iran, Research Center were handled. Media were quality-controlled at beginning and in the middle of study by NCCLS [National Committee for Clinical Lab Standard] with ATCC [American Type Culture Collection] samples. Sampling, transfer, and handling were all in standard conditions usually used in hospital. Results were compared by Fisher Exact Test. Clinical diagnosis were bacterial in 84 [79%], and nonbacterial in 22 [21%] patients at admission. 57 [54%] patients had not used antibiotics in the past 72 hours. In Monophasic Media of hospital lab 2 [1.9%] positive cultures [S. epidermidis] one with history of Erythromycin use were reported. In both Monophasic and Biphasic Media in reference lab 3 [2.8%] positive cultures [2 S.epidermidis, 1 E. coli] were reported equally, one with history of Erythromycin use. Growth Index in both Monophasic and Biphasic Media were standard in quality control. Qualities of Mono and Biphasic Media in growing bacteria were alike and Biphasic Media had no superiority to Monophasic Media in routine bacterial isolation. Positive culture in both labs had no significant statistical difference. So, negative results are not due to media and laboratorial fields, and it is needed to educate and evaluate two other fields: Sampling and Transferring. Also, we may have more positive cultures by increasing blood samples from 5 to 20 ml which can be compared in next studies