CP-145 Effect of a training initiative to improve adherence to the recommendations for therapeutic monitoring vancomycin effect of a training initiative to improve adherence to the recommendations for therapeutic monitoring vancomycin

• Published in: European journal of hospital pharmacy. Science and practice Vol. 22; no. Suppl 1; p. A58
• Main Authors: Gallego Muñoz, C, Domínguez Cantero, M, Rodríguez Mateos, M, Manzano Martin, MV, Moyano Prieto, I, Guerrero Sánchez, F, Suárez Carrascosa, F, Blanco Sánchez, G, García Martín, F, Bulo Concellón, R
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.03.2015
• Subjects: Antibiotics; Creatinine
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2015-000639.139

BackgroundUp to 50% of antibiotic treatments prescribed have been estimated to be incorrect.1 This is probably caused by the high level of knowledge required for the appropriate use. Training may be a way to improve antibiotic use.PurposeTo analyse the impact of training on the correct use of trough vancomycin plasma concentrations as a tool for monitoring effectiveness and safety in a teaching hospital.Material and methodsThe training was conducted by disseminating local antibiotic guidelines including the recommendations contained in the consensus document on therapeutic monitoring of vancomycin.2 A before-after study was conducted comparing before the training period (January–April 2012) with a later period (September–December 2013). We selected patients treated with vancomycin and we collected data on duration and concomitant treatment, demographic variables, serum creatinine before and during treatment. Creatinine clearance was calculated by MDRD-4, considering impaired renal function ?? <80 ml??/min. To compare the two periods the McNemar-Bowker test (SPSS v.15) was used.Results85 patients were treated with intermittent infusion of vancomycin, 30 patients before vs. 45 after the training. The median age was 66 vs. 65 years. Mostly men, 70% vs. 55.6%. Median days of treatment were 7 [7 (1–46) vs. 7 (1–24)]. No levels were requested in 90% vs. 73.3% for the two periods, which met one or more criteria; monitoring was 63% vs. 51.1%, no statistically significant difference (p = 0.379). The criterion of more than five days duration was 100%; monitoring was 86.9% in both periods.ConclusionThe implementation of an educational activity did not meet expectations in terms of an increase in adherence to recommendations. It is necessary to intensify these training activities and the role of the clinical pharmacist on the usefulness and advantages of monitoring vancomycin, particularly during prolonged treatment. References and/or AcknowledgementsDellit TH. Clin Infect Dis.Rybak M. Am J Health Syst PharmNo conflict of interest.