Work

Evaluation of vancomycin utilization in medical and pediatric wards: a retrospective cross-sectional study at Bule Hora University Teaching Hospital, Ethiopia

Year: 2025

Type: article

Abstract: BACKGROUND: Vancomycin is a critical antibiotic used for serious Gram‑positive infections, particularly methicillin‑resistant Staphylococcus aureus (MRSA). However, inappropriate use contributes to antimicrobial resistance (AMR). Limited evidence exists on the extent and appropriateness of vancomycin utilization in Ethiopian hospitals. OBJECTIVES: To evaluate the prescribing pattern and appropriateness of vancomycin use in medical and pediatric wards at Bule Hora University Teaching Hospital (BHUTH). METHODS: A retrospective cross‑sectional study was conducted among 182 patient medical records reviewed. Data were extracted using a structured checklist adapted from the Ethiopian Standard Treatment Guidelines (STG). Patient sociodemographic characteristics, clinical profiles, vancomycin prescribing pattern, appropriateness, and outcomes were assessed. Data were analyzed using the Statistical Package for the Social Sciences version 27. Descriptive statistics were employed and results presented in tables and figures. RESULTS: Of 182 patients admitted, 81 (44.8%) received vancomycin, mainly for pyogenic meningitis (78.9%) and severe community‑acquired pneumonia (13.3%). Prescribing appropriateness was 84.6% for indication, 96.3% for dose, and 98.7% for frequency, but lower for duration (71.6%). All prescriptions were empirical, with no microbiological confirmation. Ceftriaxone was the most frequent co‑prescribed drug (42.0%). Among vancomycin recipients, 74.1% improved, 11.1% died, and no adverse drug reactions were documented. CONCLUSION: Vancomycin utilization at BHUTH demonstrated generally appropriate indication, dosing and frequency, but all prescriptions were empirical, without microbiological confirmation, and nearly one‑third had inappropriate treatment duration. These practices increase the risk of antimicrobial resistance, especially given vancomycin's WHO AWaRe classification as a Watch antibiotic.

Source: BMC Infectious Diseases

DOI: 10.1186/s12879-025-11820-7

Authors: Aliyi Gerina, Woyesa Elema, Netsanet Fikadu, Misgana Amanual

Institution: Bule Hora University

Language: English

Topic: Antibiotic Use and Resistance

Subfield: Applied Microbiology and Biotechnology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,090