effects of pharmacist intervention on the utilization of vancomycin in a teaching hospital
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abstract
in order to investigate the effect of pharmacist intervention on vancomycin use, this study was performed on all patients receiving vancomycin in the intensive care unit (icu) and hematology-oncology ward of taleghani educational hospital in tehran, iran. vancomycin use was assessed during a pre- and post-intervention period in accordance with the center of disease control and prevention (cdc) and infectious diseases society of america (idsa) guidelines. following the intervention, there was a significant change in appropriate initiation of vancomycin (p = 0.009) and no significant improvement was observed in adequate dosage and the duration of therapy (p = 0.15 and p = 0.54 respectively); however, informing the physician resulted in discontinuation of the drug in 50% of inappropriate cases and vancomycin dosage was adjustedin 31% of cases. temperature charts, culture results and pre-treatment cbc tests changed significantly (p = 0.02, p = 0.009 and p = 0.04 respectively). the rate of infusion related adverse drug reactions did not decrease significantly (p = 0.06); yet in 100% of patients, these reactions were resolved after notifying the nursing team. after pharmacist intervention,vancomycin use improved in some aspects. a significant improvement in appropriate initiation of therapy was observed; however, treatments continued despite negative cultures. it is necessary to optimize the use of vancomycin by performing more educational interventions.
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Journal title:
iranian journal of pharmaceutical researchجلد ۱۴، شماره ۴، صفحات ۱۲۸۱-۱۲۸۸
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