Safety and efficacy of vancomycin therapy in a tertiary care hospital: A prospective observational study

Abstract

Background: Vancomycin is widely used to treat infections caused by Gram-positive organisms. However, its use results in several clinically significant side effects in human beings. This study focuses on the safety and clinical outcomes of vancomycin therapy and its judicious use in hospitalized patients. Materials and Methods: A prospective observational study was conducted over a period of 6 months in Lourdes Hospital, Ernakulam. Demographic and clinical details, including pertinent laboratory values of patients prescribed with vancomycin during hospitalization, were documented and analyzed using a specifically designed data collection form. Results: Positive clinical outcomes were observed in a study of 60 patients treated with vancomycin for various infections, although two died within 30 days. The average duration of therapy was 6.86 days, and the average length of hospital stay was 12.23 days. Nephrotoxicity was observed in 5% of patients, with 11.6% developing acute kidney injury network (AKIN) Stage 1 and 5% progressing to Stage 2. Laboratory results demonstrated recovery from infection (reflected by reduced neutrophil and erythrocyte sedimentation rate levels) alongside a slight increase in creatinine levels and a significant decrease in urea levels. Adverse drug reactions were reported in 19 patients (31.7%). Conclusion: This study assessed the safety and efficacy of vancomycin, highlighting nephrotoxicity in 16.6% of patients. Despite some adverse reactions, there were favorable responses in 90% of the cases. Doses were administered according to standard guidelines. The study’s findings contributed to developing proposed guidelines for vancomycin use in collaboration with the Nephrology Department.

Keywords

• akin criteria; nephrotoxicity; standard guidelines; vancomycin therapy