Epidemiology of vancomycin usage at a children's hospital, 1993 through 1995.
OBJECTIVE
To describe the epidemiology of vancomycin usage at a children's hospital.


METHODS
A cohort study of patients at Egleston Children's Hospital who were charged for the receipt of vancomycin from October, 1992, through October, 1995, was performed. Data were obtained from pharmacy charge records in the hospital's medical records information system.


RESULTS
During the study period there were 3589 patient hospitalizations in which vancomycin was used. Patients receiving vancomycin were predominantly male (56.6%) and white (62.4%), ranged in age from 0 to 31 (median, 3.8) years and had an average length of stay of 6.0 days. The total number of vancomycin doses was 105,704; the median number of vancomycin doses during each patient hospitalization was 11.0 (range, 1 to 1215). The total charge for vancomycin used was $2,009,746; the median charge for vancomycin per patient was $297.50 (range, $11 to 19,864). The majority (75.7%) of vancomycin doses were given on the hematology (27.6%), neurosurgery (17.9%), cardiothoracic surgery (13.4%), neonatology (9.7%) or general pediatrics (7.1%) services. Overall surgery service patients were significantly more likely to receive vancomycin than were medicine service patients (1267 doses/6221 admissions vs. 1954/19,446; relative risk, 2.03; P < 0.001). During the study period the number of vancomycin doses decreased significantly (P < 0.001).


CONCLUSIONS
This study shows the value of evaluating antimicrobial use through a pharmacy database. Although vancomycin use decreased during the study period, large amounts of vancomycin are still being prescribed primarily on subspecialty service patients. Interventions to reduce vancomycin use should focus on these groups.
Sinkowitz
R L
RL
Hospital Infections Program, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Keyserling
H
H
Walker
T J
TJ
Holland
J
J
Jarvis
W R
WR
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005069:Evaluation Studies as Topic; D005260:Female; D005845:Georgia; D017721:Hospital Costs / Q000706:statistics & numerical data; D006748:Hospital Departments / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007275:Injections, Intravenous; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008432:Mathematical Computing; D014640:Vancomycin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*
D014640:Vancomycin