Document Detail


Effectiveness of pharmacy policies designed to limit inappropriate vancomycin use: a population-based assessment.
MedLine Citation:
PMID:  12452297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In Oregon in 1994, a population-based study of 66 nonpsychiatric hospitals indicated that 40% of vancomycin orders were inappropriate according to Centers for Disease Control and Prevention guidelines. We repeated the study to determine whether vancomycin use had been affected by pharmacy policies implemented following the 1994 study. METHODS: We surveyed pharmacists in nonpsychiatric hospitals in Oregon regarding vancomycin use policies in their hospitals. Using pharmacy records, we identified and abstracted the charts of all patients in Oregon hospitals receiving vancomycin during a 3-week period to determine appropriate use of vancomycin. RESULTS: Thirteen (20%) of 64 hospitals had implemented a vancomycin restriction policy since 1994; none ofthe remaining hospitals in the study had a policy. In 1999, hospitals with vancomycin restriction policies had substantially decreased rates of inappropriate vancomycin use compared with hospitals without such policies (1.0 vs 1.8 orders per 1,000 patient-days; P = .01). Compared with 1994 baseline rates of inappropriate use, hospitals that adopted policies experienced a decrease (from 1.5 orders per 1,000 patient-days in 1994 to 1.0 in 1999; P= .13), whereas hospitals without policies experienced a statistically significant increase (from 0.9 orders per 1,000 patient-days in 1994 to 1.8 in 1999; P= .001). Restriction policies were most effective at reducing rates of inappropriate use for treatment of confirmed gram-positive infections and prophylaxis. CONCLUSION: Vancomycin restriction policies were associated with a decrease in inappropriate therapeutic and prophylactic vancomycin use, but had no effect on inappropriate empiric use. Hospitals considering limits regarding inappropriate use should consider implementation of institution-based vancomycin restriction policies as part of an overall strategy.
Authors:
Ann R Thomas; Paul R Cieslak; Larry J Strausbaugh; David W Fleming
Related Documents :
10351677 - Health services reform and human resource management in hong kong public hospitals.
15519817 - Barrier precautions, isolation protocols, and personal hygiene in veterinary hospitals.
17570557 - International migration patterns of physicians to the united states: a cross-national p...
6731637 - Psychiatric catchment areas in an urban center: a policy in disarray.
3640737 - The nosocomial colonization of t. bear.
10168057 - Physicians.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America     Volume:  23     ISSN:  0899-823X     ISO Abbreviation:  Infect Control Hosp Epidemiol     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-11-27     Completed Date:  2003-02-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8804099     Medline TA:  Infect Control Hosp Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  683-8     Citation Subset:  IM; N    
Affiliation:
Division of Applied Public Health Training, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / pharmacology,  therapeutic use*
Centers for Disease Control and Prevention (U.S.)
Cross Infection / drug therapy,  microbiology,  prevention & control*
Drug Utilization Review / organization & administration*
Gram-Positive Bacterial Infections / diagnosis,  drug therapy*,  prevention & control
Health Services Misuse / statistics & numerical data
Humans
Infection Control / standards*
Oregon
Organizational Policy*
Pharmacy Service, Hospital / organization & administration*,  standards
Practice Guidelines as Topic
United States
Vancomycin / pharmacology,  therapeutic use*
Vancomycin Resistance
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 1404-90-6/Vancomycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Epidemiology of methicillin-susceptible Staphylococcus aureus in the neonatal intensive care unit.
Next Document:  Nosocomial infection among children with symptomatic human immunodeficiency virus infection.