Abstract

Title : Drug use review and pharmaceutical care service in therapeutic drug monitoring of Vancomycin, Sunpasit Thiprasong Hospital, Ubon Ratchathani
By : Napassorn Tantaopas and Rutchanikorn Khaolaaead
Degree : DOCTOR OF PHARMACY
Advisor : Peerawat Jinatongthai and Dr.Tatta Sriboonruang
Keywords : vancomycin, drug use review, therapeutic drug monitoring
   
Vancomycin is the main therapy for antibiotic-resistant gram-positive bacteria. Due to its properties with narrow therapeutic index and high adverse drug events, annually drug use review is required to promote the appropriate using. Objectives: To review the use of vancomycin and the result of pharmaceutical care service in therapeutic drug monitoring. Methods: The retrospectively descriptive analysis by using electronic medical record from hospital database was performed among patient received intravenous vancomycin during October 1st 2014 to September 30th 2015. Results: Vancomycin was prescribed in 319 patients (403 prescription). Most of them were male (60.80%). The average body weight was 56±9 kg. Most of indication was septicemia, lower respiratory tract infection andskin infection (22.08%, 21.59%, and 17.87%, respectively). The average dosage of vancomycin was 14.79 ± 3.33 mg/kg. All of vancomycin was prescribed with administration period not less than 60 min. Nephrotoxicity was the most report of adverse effect (5.46%). Drug level was monitored only 38.96% among vancomycin prescriptions. Of these, 27.39% were in therapeutic range. However, 96.82% of report level were monitored and were interpreted by clinical pharmacist. Dosage adjustment was compatible with suggestion by clinical pharmacist for 68.42%. Conclusion: The use of vancomycin was generally consistent with the recommendation from clinical practice guideline in terms of indication, dosage, and duration of treatment. Pharmacist should participate for therapeutic drug level to encourage the treatment.
   
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