Rational Use of Vancomycin Among Inpatients in Shahid Chamran Hospital; A Cross-Sectional Study

The rational use of drugs is one of the main elements of
achieving the best pharmacotherapy method. By contrast, the irrational use
of drugs imposes many problems on healthcare systems worldwide. Since the irrational
and inappropriate prescription of antibiotics is one of the main underlying factors of
global threat of increased antibiotic resistance, it is of utmost importance to evaluate the
rational use of widely used antibiotics in the healthcare system. Vancomycin is used for
infections caused by gram-positive bacteria, including Methicillin-resistant
staphylococci and enterococci, but the inappropriate use of this drug has led to the
emergence of Vancomycin-resistant strains. The purpose of this study was to investigate
the manner of Vancomycin prescription in Chamran Hospital of Isfahan.
This cross-sectional study was
conducted on 402 patients admitted to Shahid Dr. Chamran Heart Hospital of Isfahan in
the period of 6 months (from September 1, 2021 to Feburary 1, 2022). The information
of these patients was recorded through a checklist, including the demographic
information of the patient, the drugs used, the reason for hospitalization, the number of
days of hospitalization, the reason for vancomycin prescription and its starting time, and
other information. Then, the matching or non-matching of drug prescription was
investigated based on the diagnosed disease.
The Blood culture type with a frequency of 6.2% and the Pericardia culture
type with a frequency of 0.2% had the highest and lowest frequency in the studied
subjects, respectively. 36.8% of those who used Vancomycin also used Ceftriaxone.
81.8% of those who used vancomycin used it for prophylaxis. The frequency of rational
prescription in people with endocarditis indication was significantly higher than people
without this indication. Also, the frequency of rational and irrational prescription in
prophylaxis indication is higher than other indications. The frequency of
prescribing the correct dose of medicine was 87.6%.