This study examined the effect of a sustainable, pharmacist-led education programme to improve vancomycin prescribing, following a revision of local vancomycin guidelines. The aims of the study were to describe existing vancomycin prescribing and monitoring for 20 adults patients in a surgery unit of a hospital in South Australia (pre-intervention); to develop and implement pharmacist-led vancomycin dosing and monitoring guidelines; and, to evaluate the effect of the guideline implementation programme on prescriber behaviour and patient vancomycin concentrations (post-intervention). The findings of the study showed that the provision of a pharmacist-led implementation of vancomycin dosing and monitoring guidelines improved loading and maintenance dose prescribing and the achievement of target concentrations. The numbers of subtherapeutic and potentially toxic concentrations were also reduced. The improved adherence to treatment guidelines may thus lead to greater treatment efficacy and lower rates of antibiotic resistance.
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