title: Effects of Pharmacist Intervention on the Utilization of Vancomycin in a Teaching Hospital.
abstract: In order to investigate the effect of pharmacist intervention on vancomycin use, this study was performed on all patients receiving vancomycin in the intensive care unit (ICU) and hematology-oncology ward of Taleghani Educational Hospital in Tehran, Iran. Vancomycin use was assessed during a pre- and post-intervention period in accordance with the Center of Disease Control and prevention (CDC) and Infectious Diseases Society of America (IDSA) guidelines. Following the intervention, there was a significant change in appropriate initiation of vancomycin (P = 0.009) and no significant improvement was observed in adequate dosage and the duration of therapy (P = 0.15 and P = 0.54 respectively); however, informing the physician resulted in discontinuation of the drug in 50% of inappropriate cases and vancomycin dosage was adjustedin 31% of cases. Temperature charts, culture results and pre-treatment CBC tests changed significantly (P = 0.02, P = 0.009 and P = 0.04 respectively). The rate of infusion related adverse drug reactions did not decrease significantly (P = 0.06); yet in 100% of patients, these reactions were resolved after notifying the nursing team. After pharmacist intervention,vancomycin use improved in some aspects. A significant improvement in appropriate initiation of therapy was observed; however, treatments continued despite negative cultures. It is necessary to optimize the use of vancomycin by performing more educational interventions.
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Maria
authors.initials: M
authors.lastname: Tavakoli-Ardakani
authors.affiliation: Student Research Committee, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Samaneh
authors.initials: S
authors.lastname: Ghassemi
authors.affiliation: Division of Infectious Diseases, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Afshin Mohammad
authors.initials: AM
authors.lastname: Alizadeh
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Salamzadeh
authors.affiliation: Department of Hematology-Oncology, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Ghadiani
authors.affiliation: Student Research Committee, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sara
authors.initials: S
authors.lastname: Ghassemi
keywords: Antibiotic use; Drug use evaluation; Guidelines; Pharmacist intervention; Vancomycin