A PROSPECTIVE OBSERVATIONAL STUDY ON UTILISATION OF VANCOMYCIN IN PAEDIATRIC INPATIENTS IN TERITIARY CARE HOSPITAL

*Thanneeru Vishnupriya, Pharm-D, Ganta Jahnavi, Pharm-D, Bandi Shashi Kumar, Pharm-D, Dr. Gonepally Vaishnavi, Pharm-D and Padma Padma, Pharm-D

ABSTRACT

Vancomycin is a glycopeptide antibiotic used to treat number of various disease conditions(especially bacterial infections). Vancomycin is frequently inappropriately prescribed, especially as empirical treatment. It is considered appropriate for treating beta lactum resistant gram positive microorganisms, but is inappropriate for beta lactum susceptible microorganisms unless the patient is severely allergic to beta lactum antimicrobials. Aims and Objectives: To study the empirical use of vancomycin in hospitalized pediatric patients and to optimize the inappropriate prescribing patterns of vancomycin. Methodology: This prospective study was conducted over a period of 6months in 2018 to identify the inappropriate vancomycin prescription in hospitalized pediatric patients in tertiary care hospitals. The necessary data was collected from the inpatient case notes, treatment charts, patient attendants, and nursing staff. The data was analysed based on the culture sensitivity reports, indications for vancomycin prescription, duration of therapy with vancomycin, chances for drug interactions, vancomycin dosing consideration. Results: In our study, it was found that out of 166 patients, 138 (83.13%) patients were treated with vancomycin empirically and in 28 (16.86%) patients vancomycin was given after specific diagnosis. Conclusion: Infants were mostly affected with various diseases. Therapy with vancomycin was continued even though the culture sensitivity reports did not necessitate the use of vancomycin. In such conditions therapy may be shifted to other antibiotics. In certain cases weight was not considered in vancomycin therapy. This may result in sub-optimal therapeutic outcomes or toxicity. We also found that majority of patients were treated with vancomycin empirically, even though its use was not really required.

Keywords: Vancomycin, Empirical treatment, Culture sensitivity tests, Paediatrics.