Author/Authors :
Dehghan Farzaneh نويسنده Shiraz University, , Shoaei Simin Dokht نويسنده Department of Infectious Diseases and Tropical Medicine , Davoodian Parivash نويسنده Infectious Disease Research Center, Hormozgan University of Medical Sciences, Bandar Abbass, Iran. , Shirvani Fariba نويسنده Department of Pediatrics, Pediatric Infections Research Center, Mofid Children Hospital. Shaheed Beheshti University of Medical Sciences and Health Services, Tehran, Iran , Zolghadri Nader نويسنده Department of Mathematics, Islamic Azad University, Sama
Colledge, Bandar Abbas, Iran , Taslimi Taleghani Naeeme نويسنده Mahdieh Medical Center, Shahid Beheshti University of
Medical Sciences, Tehran, IR Iran , Khorami Narges نويسنده Hormozgan Social Security Management - Khalij Fars Hospital of Social Security, Bandar Abbas , Bassiri Azita نويسنده Department of Pediatrics - Mahdiye Educational Hospital - School of Medicine - Shahid Beheshti University of Medical Sciences, Tehran
Abstract :
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.
