INVESTIGATION OF VANCOMYCIN USAGE IN ELDERLY PATIENTS AT FRIENDSHIP HOSPITAL

Bá Hải Lê, Thị Minh Hoàng, Thị Xuân Phương Đồng, Chí Kiên Phùng, Thị Thu Thủy Nguyễn, Vân Anh Lê, Thị Thu Hương Nguyễn, Thị Chi Đinh, Thị Thúy Vân Phạm

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Abstract

Objective: To describe the usage characteristics of vancomycin in elderly patients at Friendship Hospital after implementing a preauthorization process with the contribution of a clinical pharmacist. Subjects and methods: Retrospective descriptive study based on data obtained from medical records of elderly inpatients (≥ 60 years old) at Friendship Hospital during the period from 01/6/2022 to 31/5/2023 treated with vancomycin intravenously for at least 24 hours. Results: The median age of the patients was 82 years old, men accounted for 75.8%. Patients discharged from the hospital with recovery/ improvement account for 56.7%. Vancomycin is prescribed empirically in 70% of patients. The rate of patients undergoing microbiological culture was 93.3%, of the 104 specimens with positive results, Staphylococcus aureus accounted for 26.9%, Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 23.1%. Loading dose regimen was applied in 97.5%. The common maintenance doses were 1g/24h (54.5%) and 1g/12h (30.9%). The rate of patients experiencing nephrotoxicity was 7.5%. Conclusion: The activities of clinical pharmacists have had a positive impact on the usage of vancomycin as the rate of patients prescribed an appropriate loading dose and the maintenance dose was determined to be appropriate for kidney function at the beginning of treatment is high. However, the study noted that a certain proportion of patients did not receive appropriate dose adjustment when kidney function changed. Therefore, Friendship Hospital needs to promote therapeutic drug monitoring of vancomycin, especially as the patient population has a very high age.

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References

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