Showing 3 results for Vancomycin
Khalili H, Gholami Kh, Hajiabdolbaghi M, Sairafipoor Z,
Volume 64, Issue 12 (11-2006)
Abstract
Background: Drug Utilization Evaluation (DUE) studies are performed to define, determine, and finally improve the quality of drug usage. These types of studies are especially valuable for drugs with a narrow therapeutic index or specific indication, or for expensive medications. In Iran, vancomycin is only available by prescription for methicillin-resistant staphylococcal and enterococcal infections. It is obvious that extensive and irrational use of this drug can increase bacterial resistance to this antibiotic. The goal of this study was to assess vancomycin utilization.
Methods: In a descriptive cross-sectional study performed during the fall and winter of 2004, this vancomycin DUE was done in the Infectious Disease Department of Imam Khomeini Hospital in Tehran. All of the patients receiving vancomycin were enrolled in this study. The Centers for Disease Control (CDC) and American Society of Hospital Pharmacists (ASHP) protocols have been used to perform this study.
Results: Of the 565 inpatients at this hospital, 39 subjects (7%) received vancomycin. Vancomycin utilization among these patients was compatible with CDC and ASHP protocols in only 28% and 35% of the patients, respectively.
Conculusion: Vancomycin is predominantly administered empirically, rather than being based on the antibiogram. This may be due to the routine protocol of the ward or the physician doubting the reliability of the antibiogram.
Mohammad Kazem Sharifi Yazdi , Mohammad Mehdi Soltan Dallal,
Volume 71, Issue 4 (7-2013)
Abstract
Background: The role of gram-positive cocci especially Staphylococci species in causing urinary tract infection are well known. Among the Staphylococci species Methicillin Resistance Staphylococcus aureus (MRSA) is the most important. The rate of MRSA is increasing worldwide. This is alarming because the danger of these organism in public health. Therefore the aim of this study was to determine the sensitivity of gram-positive cocci, as well as MRSA to vancomycin and other antibiotics.
Methods: This was a descriptive study, and were carried out on 300 patients with urinary tract infections (UTI) caused by gram-positive cocci, referred to Imam Khomeini hospital during eight months. Prior to the antibiotic sensitivity testing all the isolates were identified according to the standard conventional biochemical procedure, and then the antibiotic susceptibility test were carried out according to Bauer-Kirby method.
Results: Among the gram positive cocci causing UTI, the most abundant were Staphylococcus saprophyticus (37.7%), followed by Staphylococcus epidermidis (22.3%) and Staphylococcus aureus (18%) respectivley. The sex distribution of patients were 163 female (54.3%) and 137 male (45.7%) respectively, and the prevalence rate of urinary tract infections in female was (8.6%) higher than male. The rate of sensitivity of isolated Staphylococci were as followed, sensitive to vancomycine (100%), Ciprofloxacin (89.2%), rifampin (87.6%), and amikacin (71.8%) respectivley, but were resistant to penicillin and amoxicillin (100%). The antibiotic sensitivity rate of isolated Streptococci was to vancomycine (85.1%), ciprofloxacin (50.7%) and penicillin (79.1%) respectively.
Conclusion: Vancomycin is still a suitable antibiotic for the treatment of Staphyloco-ccus infections. Although 6% rate of enterococci resistance to vancomycin is alarming, and use of this antibiotic in the treatment of other gram-positive bacteria should be done with precaution.
Ehsan Roshan Nasab , Farzaneh Hematian, Ahmad Shamsizadeh Hayatdavodi, Mohammadreza Mirkarimi , Mohsen Ali Samir , Mandana Izadpanah,
Volume 82, Issue 6 (9-2024)
Abstract
Background: Vancomycin resistance in intensive care units has significant complications and additional costs. Given the need for rational use of this antibiotic to prevent the occurrence of antibiotic resistance, the present study was designed to evaluate how to prescribe the antibiotic vancomycin consumption pattern in a pediatric subspecialty hospital.
Methods: This cross-sectional descriptive-analytical study was conducted over a 3-month period (February, May, and June) in 2021 at the Pediatric Hospital of Jundishapur University of Medical Sciences, Ahvaz. All patients hospitalized in the intensive care unit and infectious disease ward with vancomycin prescription were included in the study. Patients who were hospitalized for less than three days or had no desire to enter the study were excluded from the study. Vancomycin prescription by clinical pharmacist was reviewed based on the latest version of Lexicomp from Wolters Kluwer and the National Health Service (NHS) guidelines.
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Results: Of the 91 hospitalized patients, 70.3% (64 cases) were prescribed vancomycin without performing an antibiogram culture based on experience and 29.7% (27 cases) were based on an antibiogram culture. In 96.7% (88 cases) , the duration of intravenous vancomycin infusion did not comply with the protocol. Red Man Syndrome was observed in 8.8% (8 cases). In 91.2 % (83 cases), no adverse effects were reported. In 65.9% (60 cases), the drug dose was determined based on the correct renal function Glomerular filtration rate (GFR) and in 34.1%, the drug dose was determined regardless of the renal function of the patients. Vancomycin doses were lower and higher than the guidelines in 6 and 25 patients, respectively. Out of all patients, eighty four cases recovered and seven cases died.
Conclusion: In almost half of the patients, Vancomycin were prescribed based on experience and without performing an antibiogram test. Use of guidelines, Serum level monitoring programs and continuous medical education for doctors can be effective in rational use of antibiotics.
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