Vancomycin Utilization Evaluation in a Tertiary Teaching Hospital in Mashhad, Iran

  • Mohaddeseh Sadat Ayubi Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Sepideh Elyasi Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Mahdi Jannati Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Naser Vahdati-Mashhadian Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Department of Pharmacodynamics and Toxicology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Mohammad Reza Saberi Medical Chemistry Department, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
  • Hamid Reza Naderi Department of Infectious Disease, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  • Amir Hooshang Mohammadpour Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
Keywords: Drug Utilization Review, , Vancomycin, Infection, Medication Errors

Abstract

Introduction: Inappropriate use of antibiotics in health care systems can lead to bacterial resistance, nosocomial infections and increased hospital costs. So, evaluation programs for these medications are needed. This study evaluates the pattern of vancomycin utilization in Imam Reza hospital, Mashhad, Iran. Methods: At first, according to drug information sources a check list was designed for appropriate indication and dosing of vancomycin. One hundred patients were selected randomly from different wards of hospital during a 6 months period and their data were collected in predesigned check list. Then, data were evaluated according to prepared checklist.Results: In this study, 100 patients (48 female and 52 male) were evaluated. Empiric therapy in 20% of patients was not initiated appropriately based on prepared checklist. Empiric regimen was changed in 10 patients based on culture results and in 28 patients regarding clinical response. Prescribed doses were according to the guideline in only 31% of patients. Duration of treatment were inappropriate in 35 patients. Vancomycin induced nephrotoxicity occurred in 7 patients and red man syndrome in 1 patient. Administration procedure was correct in all patients. Conclusion: According to the results, lots of error occurred in vancomycin administration and dosing in our center. It is necessary to develop localized guideline for vancomycin utilization in this hospital to prevent unwanted adverse reactions and antimicrobial resistance and also reduce treatment cost. 

References

Organization WH. WHO policy perspectives on medicines. Promoting rational use of medicines: core components Geneva. 2002.

Holloway K. Promoting rational use of medicines. Contact a publication of world council of churches. 2006;183:2-3.

Jetacar M. The use of antibiotics in food-producing animals: antibiotic-resistant bacteria in animals and humans. Report of the Joint Expert Advisory Committee on Antibiotic Resistance. 1999.

Belongia EA, Schwartz B. Strategies for promoting judicious use of antibiotics by doctors and patients. Bmj. 1998;317(7159):668-71.

Radyowijati A, Haak H. Improving antibiotic use in low-income countries: an overview of evidence on determinants. Social science & medicine. 2003;57(4):733-44.

Davey P, Pagliari C, Hayes A. The patient's role in the spread and control of bacterial resistance to antibiotics. Clinical Microbiology and Infection. 2002;8(s2):43-68.

Fahimi F, Soleymani F, Tavakoli-Ardakani M. Vancomycin Utilization Evaluation in a teaching hospital: A case-series study in Iran. Journal of Pharmaceutical Care. 2015;1(2):51-4.

Vazin A, Japoni A, Shahbazi S, Davarpanah MA. Vancomycin utilization evaluation at hematology-oncology ward of a teaching hospital in Iran. Iranian journal of pharmaceutical research: IJPR. 2012;11(1):163.

Tavakoli-Ardakani M, Ghassemi S, Alizadeh AM, Salamzadeh J, Ghadiani M, Ghassemi S. Effects of pharmacist intervention on the utilization of vancomycin in a teaching hospital. Iranian journal of pharmaceutical research: IJPR. 2015;14(4):1281.

Salehifar E, Babamahmoodi F, Alikhani A, Ganji R, Fazli M. Drug utilization evaluation of vancomycin in a referral infectious center in mazandaran province. Journal of Pharmaceutical Care. 2015;2(2):55-9.

Hamishehkar H, Ebrahimi D, Mahmoodpoor A, Mashayekhi S, Asgharian P, Reazee H. Drug utilization evaluation of vancomycin in a teaching hospital in Tabriz-Iran. Pharmaceutical Sciences. 2015;21(1):25.

Salemi C, Becker L, Morrissey R, Warmington J. A clinical decision process model for evaluating vancomycin use with modified HICPAC guidelines. Hospital Infection Control Practice Advisory Committee. Clinical performance and quality health care. 1998;6(1):12-6.

Evans ME, Kortas KJ. Vancomycin use in a university medical center: comparison with hospital infection control practices advisory committee guidelines. Infection Control & Hospital Epidemiology. 1996;17(6):356-9.

Melo DOd, Sasaki M, Grinbaum RS. Vancomycin use in a hospital with high prevalence of methicillin-resistant Staphylococcus aureus: comparison with Hospital Infection Control Practices Advisory Committe Guidelines (HICPAC). Brazilian Journal of Infectious Diseases. 2007;11(1):53-6.

Floret N, Thouverez M, Talon D, Thalamy B, Estavoyer J. Evaluation of vancomycin use in a large university‐affiliated hospital in eastern France in 1999. Pharmacy World and Science. 2001;23(3):93-7.

Ayazkhoo L, Mousavi S, Ramazani F, Ayatollahi-Tafti M, Sa’dabadi Z, Sistanizad M. Vancomycin Utilization Evaluation: Are We Dosing Appropriately? Journal of Pharmaceutical Care. 2015;1(4):149-52.

Khalili H, Gholami K, Hajiabdolbaghi M, Sairafipoor Z. Vancomycin Drug Utilization Evaluation in infectious disease ward of Imam Khomeini Hospital. Tehran University Medical Journal TUMS Publications. 2006;64(12):64-8.

Published
2018-08-27
How to Cite
1.
Ayubi MS, Elyasi S, Jannati M, Vahdati-Mashhadian N, Saberi MR, Naderi HR, Mohammadpour AH. Vancomycin Utilization Evaluation in a Tertiary Teaching Hospital in Mashhad, Iran. jpc. 5(3-4):44-8.
Section
Original Article(s)