Appropriate use of vancomycin in an educational tertiary care hospital in Tehran, Iran

Background: Inappropriate prescription of vancomycin has been shown to be associated with induction of antibiotic resistance. The objective of this study was to determine the incidence of inappropriate use of vancomycin in a tertiary care hospital in Iran. Methods: Adescriptive cross-sectional investigation was performed from September 2004 to March 2005 in all units of a general teaching Medical Center in Tehran. All adults and children who had vancomycin initiated in this medical center were enrolled in the study and the appropriateness of vancomycin use was determined according to Centers for Disease Control (CDC) guidelines. Results: Forty-four percent of vancomycin use was inappropriate with the highest incidence of inappropriate use occurring in surgical units. The most common inappropriate indication for vancomycin was routine surgical prophylaxis. Conclusion: Inappropriate use of vancomycin is very common in a tertiary care hospital in Iran and could potentially be decreased by educating physicians about the CDC guidelines. These educational programs should target physicians in surgical units.