Vancomycin use in a brazilian teaching hospital: comparison with the Hospital Infection Controlpractices Advisory Committee Guidelines (HICPAC)

Inappropriate Continued Empirical Vancomycin Use in a Hospital with a High Prevalence of Methicillin-Resistant Staphylococcus aureus

“…Despite the presence of these well-established guidelines, it has been reported that the proportions of inappropriately used vancomycin range between 20% and 70% (2)(3)(4)(5)(6)(7).…”

“…Although the Infectious Diseases Society of America (IDSA) recommends empirical vancomycin use in several circumstances for patients with neutropenia (9), continued empirical use of vancomycin for presumed infections in patients whose culture results are negative for beta-lactam-resistant Gram-positive microorganisms is considered inappropriate. In the guidelines of the CDC and the IDSA, it is strongly recommended that empirical vancomycin treatment be stopped when available culture results fail to reveal beta-lactam-resistant Gram-positive bacterial infections (1,9); however, it is well known that empirical vancomycin use is inappropriately continued for a proportion of patients (2,3,10,11).…”

Utilization Pattern of Vancomycin in a University Teaching Hospital in Oman: Comparison with International Guidelines

“…This finding is disturbing and may suggest a high degree of vancomycin misuse. Recent studies conducted in Western countries showed that inappropriateness in the use of vancomycin did not exceed 40 % of guidelines recommendations even in the absence of restriction policies [10][11]. At SQUH, the prevalence of β-lactamresistant Gram-positive microorganisms and infections by MRSA, compared to what is reported in most Western countries, is low [12].…”

Interações medicamentosas potenciais em prescrições, contendo antimicrobianos de uso restrito, de pacientes internados em um hospital no interior da Bahia

“…As interações medicamentosas (IM) envolvendo antimicrobianos podem ter consequências tanto para os micro-organismos quanto para o hospedeiro, sendo o risco de toxicidade, a seleção de micro-organismos resisten-tes e o maior custo ao paciente, as mais óbvias. 13,14 As reações adversas, resultantes da associação na terapia antimicrobiana, podem proceder de interações entre drogas que aumentam ou diminuem a eliminação, que alteram a ligação de proteínas ou que acentuam a toxicidade do fármaco. 15,16 Várias medidas têm sido propostas com a finalidade de diminuir o uso irracional de antimicrobianos, entre as quais as justificativas de prescrição de medicamentos considerados de reserva terapêutica ou de uso restrito.…”