Knowledge of Centers for Disease Control and Prevention guidelines for the use of vancomycin at a large tertiary care children's hospital.
OBJECTIVE
In 1994, the Centers for Disease Control and Prevention (CDC) published guidelines to encourage prudent use of vancomycin. We sought to determine whether physicians could demonstrate knowledge consistent with the guidelines.


METHODS
Survey consisting of 18 clinical vignettes based on the CDC guidelines.


METHODS
All residents, fellows, and attending physicians involved in pediatric inpatient services.


METHODS
Tertiary care children's hospital providing service to an inner-city population and community referral base.


METHODS
Comparison of survey scores and individual responses among respondents.


RESULTS
Survey scores did not vary with level of training or whether the respondent was a pediatrician or non-pediatrician. Average scores of attending physicians, fellows, and residents were 74.1% (SD = 13.1), 77.2% (SD = 11.5), and 73.4% (SD = 10.5), respectively, and did not differ significantly. Questions incorrectly answered by more than 30% of respondents concerned the use of vancomycin as: (1) first-line treatment of Clostridium difficile colitis, (2) a topical solution for wound infection, (3) initial, empiric treatment of patients with fever and neutropenia, (4) peri-operative prophylaxis, (5) a preferred agent over beta-lactam antimicrobial agents.


CONCLUSIONS
Deficits in knowledge regarding appropriate vancomycin use can be localized to certain clinical settings. This observation lends optimism to the notion that targeted educational intervention may improve the appropriate use of vancomycin.
Lin
P L
PL
Departments of Pediatrics and Health Studies and the University of Chicago Children's Hospital Pharmacy, the University of Chicago, Chicago, Illinois, USA.
Oram
R J
RJ
Lauderdale
D S
DS
Dean
R
R
Daum
R S
RS
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007396:Internship and Residency; D010820:Physicians; D017410:Practice Guidelines as Topic; D014481:United States; D014640:Vancomycin / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D014640:Vancomycin