Volume 8, Number 7—July 2002
Research
Monitoring Antimicrobial Use and Resistance: Comparison with a National Benchmark on Reducing Vancomycin Use and Vancomycin-Resistant Enterococci
Table
Prescribing practice changes implemented in response to benchmark data intervention, and mean rate of vancomycin usea before and after implementation, 50 Project ICARE ICUs, January 1996–July 1999b
| Vancomycin use prescribing practice change | No. of ICUs (%) | Vancomycin use before and after practice change |
p valuec | |||
|---|---|---|---|---|---|---|
| (n=50) | Change absent |
Change present |
||||
| Before | After | Before | After | |||
| Hospitalwided | 22 (44%) | |||||
| Drug use evaluation | 19 (38%) | 74.2 | 80.5 | 105.3 | 94.1 | 0.62 |
| Redistributed HICPAC guidelines on VRE | 9 (18%) | 79.4 | 84.6 | 116.0 | 90.6 | 0.34 |
| Prior approval of vancomycin required | 3 (6%) | 87.2 | 99.4 | 84.7 | 67.2 | 0.25 |
| Unit-specificd | 11 (22%) | |||||
| ICU-specific education on appropriate vancomycin use | 9 (18%) | 75.9 | 96.3 | 83.3 | 132.1 | 0.01 |
| Removed vancomycin from surgical prophylaxis |
3 (6%) |
82.0 |
82.2 |
85.9 |
149.1 |
0.01 |
| aDefined daily doses per 1,000 patient-days. bAbbreviations: ICARE, Intensive Care Antimicrobial Resistance Epidemiology; ICU, intensive-care units; HICPAC, Healthcare Infection control Practices Advisory Committee; VRE, vancomycin-resistant enterococci. cPaired t-test. dComponents of each major categories are not mutually exclusive, so one ICU may be represented in several components of each category. | ||||||
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