Vancomycin and teicoplanin use in Victorian hospitals. The Victorian Drug Usage Evaluation Group.
OBJECTIVE
To determine patterns of prescribing of glycopeptide antibiotics (vancomycin and teicoplanin) in Victorian hospitals and identify areas for targeted intervention.


METHODS
A concurrent, observational, multisite evaluation of drug use.


METHODS
Thirty-five Victorian hospitals, 1-14 September 1997.


METHODS
Patients commencing a glycopeptide antibiotic course.


METHODS
Rate of glycopeptide antibiotic use; indications; duration of use; main hospitals using glycopeptide antibiotics.


RESULTS
293 patients (269 adults and 24 neonates) commenced on 302 glycopeptide antibiotic courses: 296 intravenous (i.v.) vancomycin courses and three each of oral vancomycin and parenteral teicoplanin. The overall rate of use was 10.3 courses per 1000 inpatient separations. Of 271 i.v. vancomycin courses for adults, 176 (65%) were for treatment--120 empirically. The median duration of treatment courses was 4.7 days (interquartile range, 2.0-8.2 days). A flucloxacillin-resistant organism was confirmed for 44% of treatment courses. Ninety-five i.v. vancomycin courses were for prophylaxis, including for cardiac (54%) and vascular surgery (21%); 82% of prophylactic courses were administered for less than 24 hours. Of all the glycopeptide antibiotic courses, 69% were administered at five major metropolitan hospitals.


CONCLUSIONS
Glycopeptide antibiotic use in Victoria is concentrated in the major metropolitan hospitals. Prolonged durations of vancomycin therapy, including for surgical prophylaxis and empirical therapy not subsequently confirmed by microbiology findings, would be suitable targets for interventional strategies.
Robertson
M B
MB
Victorian Drug Usage Evaluation Group, Melbourne.
Dartnell
J G
JG
Korman
T M
TM
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization; D005260:Female; D005436:Floxacillin / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007263:Infusions, Parenteral; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010403:Penicillin Resistance; D010406:Penicillins / Q000627:therapeutic use; D010607:Pharmacy Service, Hospital; D017334:Teicoplanin / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use*; D014739:Victoria
D000900:Anti-Bacterial Agents; D010406:Penicillins; D005436:Floxacillin; D017334:Teicoplanin; D014640:Vancomycin