Drug Use Evaluation of Vancomycin in Pediatric Patients (II) -The effect of Approval for Vancomycin Use

Lee, Jeongmin; Lee, Soonsil; Kim, Youngjoo; Shin, Wan Gyoon; Lee, Byung Koo; Lee, Hoan-Jong

Journal of Korean Society Quality Assurance Health Care 1994;1(1): 32.
Published online May 30, 1994.

소아환자의 Vancomycin에 대한 약물사용 평가 (II) -제한항균제로 사용규제 강화 후의 효과

이정민¹, 이순실¹, 김영주¹, 신완균¹, 이병구¹, 이환종²

¹서울대학교병원 약제부
²서울대학교병원 소아과

Drug Use Evaluation of Vancomycin in Pediatric Patients (II) -The effect of Approval for Vancomycin Use

Jeongmin Lee¹, Soonsil Lee¹, Youngjoo Kim¹, Wan Gyoon Shin¹, Byung Koo Lee¹, Hoan-Jong Lee²

¹Department of Pharmacy, Seoul National University Hospital
²Department of Pediatrics, Seoul National University Hospital

Abstract

The 'Pharmacy and Therapeutic Committee' decided to restrict the use of vancomycin which was categorized into restricted antimicrobials, among general, reserved and restricted antimicrobials. The committee also established prescribing guidelines of vancomycin in Seoul National University Hospital, May, 1991. Especially, the restricted antimicrobials should be used after approval by infectious disease specialist physician. A retrospective drug use evaluation (DUE) on vancomycin has been conducted to compare with the previous vancomycin DUE study in 1990. 'Criteria for DUE on vancomycin' was modified from Am J Hosp Pharm. Total 65 charts of patients were retrospectively reviewed from July 1991 to June 1992 in Seoul National University Children's Hospital. The justification of use was improved from 56% to 75% comparing with the previous study. In analyzing process indicators, several criteria including body temperature monitoring, WBC monitoring and use of concomitant antibiotics were well documented, but serum creatinine monitoring, culture and sensitivity test and level monitoring were infrequently performed, while the accepted level has been improved. Accepted level for appropriate initial dosage and duration of therapy were decreased. In outcome analysis, blood culture after discontinuing the drug was relatively well documented compared with the previous study. As the results, the approval vancomycin use was shown to be effective and rational in antibiotic therapy. And it is suggested that the above findings should be communicated to the medical staff, and a active intervention, such as feedback control, also be necessary for rational drug use.

Key words Drug use evaluation;Vancomycin;Pediatrics;Restricted antimicrobials;Approval;