| DOI: 10.29090/psa.2024.01.23.1019 | Pharm Sci Asia 2024; 51(1), 52-58 |
Prescribing patterns and efficacy of oral vancomycin for Clostridium difficile infection in Thai patients: A single center studyWiraphol Phimarn1, Pornnutcha Kidrai1, Anisarawan Thongtun1, Pichitra Srimaya2, Panchalee Rattanasakornkul2 Ampika Changpat1, Piangkwan Srimongkhol1, Kritsanee Saramunee1, Pemmarin Potisarach1*
1 Faculty of Pharmacy, Mahasarakham University, 41/20 Khamriang Sub-District, Kantharawichai District, Maha Sarakham Province, Thailand
2 Suddhavej Hospital, Faculty of Medicine, Mahasarakham University, 79/99 Nakornsawan Road, Talat Sub-District, Muang District, Maha Sarakham Province, Thailand
Clostridium difficile infection (CDI) is a bacterial infection caused by Clostridium difficile (CD). The incidence and prevalence of CDI have increased, presenting a significant problem. Treatment of non-severe, initial CDI generally involves the administration of the antibiotic vancomycin as recommended by the guidelines. However, discrepancies still exist between the use of low and high dose of vancomycin in clinical practice, generating confusion for pharmacists due to the inconsistency of prescribed oral vancomycin patterns. The aim of this study was to investigate the prescribing patterns of oral vancomycin and its outcomes in adult patients diagnosed with non-severe, initial CDI. A retrospective chart review study was performed in 67 patients between January 1, 2015 and October 1, 2022. We analyzed the patterns of prescribed oral vancomycin including dose, frequency, and duration. Fisher’s exact test was used to compare oral vancomycin doses and their clinical outcomes. Of the 67 patients, 44 participants met the inclusion criteria. Four prescribing patterns were discovered: 1) vancomycin 125 mg PO every 6 hours (81.8%), 2) vancomycin 250 mg PO every 6 hours (9.1%), 3) vancomycin 500 mg PO every 6 hours (2.3%), and 4) others (6.8%) (250 mg PO every 24 hours and 125 mg PO every 8 hours). The association between low and high dose of oral vancomycin and clinical outcomes was found to have no statistically significant difference (p=1.000). The results from this study could be used as fundamental information for protocol development in clinical settings.
Keyword:
Clostridium difficile, Clostridium difficile Infection, Vancomycin, CDI
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