Vancomycin use in a rural hospital: a 3-year retrospective study

Introduction: Urban centres often perform audits of vancomycin use as they face outbreaks of resistant organisms. We undertook this study to understand the indications and duration of intravenous vancomycin in a rural setting. Methods: We conducted a retrospective chart audit for all patients who received intravenous vancomycin over a 3-year period at a rural hospital in northwestern Ontario. Results: Vancomycin was used intravenously in 180 patients during the study period. It was used for short courses (median 3 d), and serum levels were below target 72% of the time. Conclusion: High rates of invasive methicillin-resistant Staphylococcus aureus bacteremia and limited antibiotic choices in the field likely contributed to short courses of this antibiotic. Further study on clinical severity and antibiotic choice is needed. Additionally, weight-based dosing may result in target serum levels being achieved more frequently.