Volume 82, Issue 6 (September 2024)
Tehran Univ Med J 2024, 82(6): 476-484 |
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Roshan Nasab E, Hematian F, Shamsizadeh Hayatdavodi A, Mirkarimi M, Ali Samir M, Izadpanah M. Prospective drug utilization evaluation of vancomycin in a specialized and sub-specialized pediatric referral hospital in Ahvaz. Tehran Univ Med J 2024; 82 (6) :476-484
URL: http://tumj.tums.ac.ir/article-1-13188-en.html
URL: http://tumj.tums.ac.ir/article-1-13188-en.html
Ehsan Roshan Nasab1 
, Farzaneh Hematian * 2, Ahmad Shamsizadeh Hayatdavodi3 , Mohammadreza Mirkarimi4 , Mohsen Ali Samir5 , Mandana Izadpanah2
, Farzaneh Hematian * 2, Ahmad Shamsizadeh Hayatdavodi3 , Mohammadreza Mirkarimi4 , Mohsen Ali Samir5 , Mandana Izadpanah2
1- Student Research Committee, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2- Department of Clinical Pharmacy, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
3- Department of Pediatric Infectious Disease, Infectious and Tropical Diseases Research Center, School of Medicine, Ahvaz Jundishapur University of Medical Sciences. Ahvaz, Iran.
4- Department of Pediatrics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
5- Department of Pediatrics, Air Pollution and Respiratory Diseases Research Center, Abouzar Hospital, School of Medicine, Ahvaz Jundishapur University of Medical Sciences Ahvaz, Iran.
2- Department of Clinical Pharmacy, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
3- Department of Pediatric Infectious Disease, Infectious and Tropical Diseases Research Center, School of Medicine, Ahvaz Jundishapur University of Medical Sciences. Ahvaz, Iran.
4- Department of Pediatrics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
5- Department of Pediatrics, Air Pollution and Respiratory Diseases Research Center, Abouzar Hospital, School of Medicine, Ahvaz Jundishapur University of Medical Sciences Ahvaz, Iran.
Abstract: (62 Views)
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.
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. |
Keywords: antibiotic resistance, large pediatric subspecialty hospital in Iran, rational drug prescription, vancomycin.
Type of Study: Original Article |
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