Study on patients of infectious diseases administered with vancomycin or teicoplanin - Assessment of fitness of antimicrobial administration -

Chang, Chul Hun; Son, Han Chul; Hwang, Kyu Yon; Park, Kwang Ok; Yang, Ung Suk

Journal of Korean Society Quality Assurance Health Care 1997;3(2): 26.
Published online March 30, 1997.

감염증 환자에서 vancomycin, teicoplanin 투여례에 대한 연구 - 항균제 투여의 적응증 평가 -

장철훈¹, 손한철¹, 황규연², 박광옥², 양웅석²

¹부산대학교 의과대학 임상병리학교실
²부산대학교병원 적정진료보장위원회

Study on patients of infectious diseases administered with vancomycin or teicoplanin - Assessment of fitness of antimicrobial administration -

Chul Hun Chang¹, Han Chul Son¹, Kyu Yon Hwang², Kwang Ok Park², Ung Suk Yang²

¹Department of Clinical Pathology, College Of Medicine, Pusan National University
²Quality Assurance Committee, Pusan National University Hospital

Abstract

Background
Glycopeptide antibiotics are the only drugs for treatment of infections due to beta-lactam-resistant Gram-positive bacteria. As the incidence of infection and colonization with vancomycin-resistant enterococci(VRE) rapidly increases, the hospital infection control practices advisory committee(HICPAC) recommends prudent vancomycin use to detect, prevent and control infection and colonization with VRE.
Methods
The inpatients admitted from September to December, 1996 in Pusan National University Hospital, with Gram-positive bacterial infections were evaluated retrospectively to see whether the administrations of glycopeptide antibiotics were appropriate or not, upon comparison with the recommendations for preventing the spread of vancomycin resistance by HICPAC.
Results
Teicoplanin has been chosen more frequently than vancomycin of the glycopeptide antibiotics. The indications of administration of glycopeptides in patients with pneumonia, wound infections, sepsis, and in febrile or neutropenic patients with malignancies were appropriate, but the use of glycopeptides for elimination of merely colonized bacteria in the oral cavity could not be excluded. Inappropriate use of glycopeptides was 10.6%, and inappropriately long-term use without positive culture for beta-lactam-resistant Gram-positive organisms was about 40% of total days of drug use.
Conclusion
It seems essential for the quality assurance committee to make a plan in teaching the HICPAC recommendations to the medical practitioners who prescribed the glycopeptides inappropriately or used for irrelevantly long to his patient, monitor and survey their use of glycopeptides prospectively and periodically, and if there are repeated inappropriate prescriptions, a certain penalty would be given to the practitioners.

Key words vancomycin;teicoplanin;glycopeptide antibiotics;