Tehran University of Medical Sciences Journal of Pharmaceutical Care 2322-4630 5 3-4 2018 08 27 44 48 EN 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. AND 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. AND Department of Clinical Pharmacy, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran 2018 06 13 2018 06 16 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.   https://jpc.tums.ac.ir/index.php/jpc/article/view/215 https://jpc.tums.ac.ir/index.php/jpc/article/download/215/143