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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

Scott K. Fridkin*, Rachel Lawton*, Jonathan R. Edwards*, Fred C. Tenover*, John E. McGowan†, Robert P. Gaynes*, and the Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Project, and the National Nosocomial Infections Surveillance (NNIS) System Hospitals
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Emory University, Atlanta, Georgia, USA

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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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