YAKHAK HOEJI (약학회지)

The Pharmaceutical Society of Korea (대한약학회)
권호 표지

Evaluation of Vancomycin Use before and after the Computerized Restricted Antibiotic Control Program

제한항균제 전산 관리 프로그램 도입 전과 후의 반코마이신 사용 평가

  • 안효초 (우석대학교 약학대학) ;
  • 이창섭 (전북대학교 의과대학 내과학교실) ;
  • 이미경 (우석대학교 보건복지대학) ;
  • 양재헌 (우석대학교 약학대학)
  • Published : 2009.06.30
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Abstract

Since 2006, the Computerized Restricted Antibiotic Control Program (CRACP) has been incorporated to facilitate a more efficient approval process of vancomycin use at the Chonbuk National University Hospital. The purposes of the study were to evaluate proper use of vancomycin and to examine if there is any improvement when administering the CRACP. The use of vancomycin was retrospectively reviewed by a medical record review based on the American Society of Hospital Pharmacists (ASHP) criteria (i.e., indication, use of critical process indicators and use of outcome measurements) and compared before (Group I) and after the CRACP (Group II). Two hundred fifty six patient records were evaluated (138 in Group I and 118 in Group II). There was a statistically significant improvement in the report of justification for vancomycin use after CRACP (42.0% vs. 62.7%, p=0.001). Out of eight critical process indicators, two indicators (appropriate cultures prior to medication [68.8% vs. 85.6%, p=0.002] and serum vancomycin level measurement [0% vs. 7.6%, p=0.001]) were significantly improved after CRACP. The total incidence of adverse effects was decreased from 14.5% to 6.8%. In addition, there was a statistically significant difference in WBC count reduction within normal range (52.8% vs. 73.1%, p=0.024). The CRACP appears to be a promising approach to improve use of vacomycin in a hospital setting. However, further evaluation for the long-term period should be performed to confirm the performance of the program.

Keywords

References

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