Glueck, Thomas and Linde, H. J. and Wiegrebe, Eckard and Lehn, Norbert and Reng, Michael and Schoelmerich, Juergen (2000) Restriction of vancomycin use in a German university hospital. MEDIZINISCHE KLINIK, 95 (2). pp. 69-74. ISSN 0723-5003
Full text not available from this repository. (Request a copy)Abstract
Background: Recently, increasing antibiotic resistance has been observed among gram-positive bacteria. However, only few isolates were found to be resistant against glycopeptides. Therefore, internationally accepted guidelines recommend a restricted use of vancomycin and other glycopeptide antibiotics in order to prevent the development of resistance against these clinically important antibiotics. In many countries, the hospital pharmacies play a key role ol and reinforcement of antibiotic formulary restrictions. In Germany, however, the hospital pharmacies usually do not take over such control functions, and most wards keep a stock of regularly used drugs including antibiotics, rich makes reinforcement of restrictions difficult. Methods: In an attempt to achieve a restriction of vancomycin use, tie pharmacy of our university hospital was advised Co deliver vancomycin to the wards only on request with a special order form signed by an attending, individually for every patient who should receive vancomycin. The efficacy of this restriction measure was evaluated in 3-month periods before and after the restriction became effective. Results: Hospitalwide, this led to a 20.1% reduction of i. v. vancomycin and an 85.7% reduction of oral vancomycin use per 1000 patient days. If the hematology/oncology units were not considered, the reduction of i. v. vancomycin use was 41.8%, and the total use after the restriction 24.2 g. per 1000 patient days. Microbiology results which justified the use of vancomycin decreased by 8.3% (10.9% hematology/oncology units not considered) between the 2 observation periods. Assuming a 7-day mean course of i. v. vancomycin therapy, the empirical of i. v. vancomycin decreased from 39.9% to 8% after the restriction had been instituted. Conclusion: Allowing only experienced physicians (attendings) to decide on the use of vancomycin therapy, proved in our experience to br an effective measure to reduce unnecessary vancomycin use.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RESISTANT ENTEROCOCCUS-FAECIUM; DIFFICILE-ASSOCIATED DIARRHEA; GLYCOPEPTIDE RESISTANCE; STAPHYLOCOCCUS-AUREUS; GUIDELINES; OUTBREAK; COLITIS; vancomycin; MRSA; GISA; VREC; antibiotic formulary |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Jun 2022 06:28 |
| Last Modified: | 07 Jun 2022 06:28 |
| URI: | https://pred.uni-regensburg.de/id/eprint/42824 |
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