Background: Antimicrobial stewardship programs (ASP) are a key component of efforts to combat antimicrobial resistance. These programs are designed to reduce to non-indicated use of antimicrobials, reduce adverse drug reactions, and provide guidance for the indicated uses of antimicrobials. We audited adherence to vancomycin use guidelines to determine if prescribers are compliant with vancomycin use guidelines and calculated the rate of non-indicated vancomycin use through chart review. 
Methods: We reviewed vancomycin prescriptions for four months in 2022 and determined if vancomycin use was indicated according to hospital guidelines. Chart review consisted of evaluating the clinician’s stated reason for starting vancomycin, if that indication was adherent to guidelines, and the duration of antibiotic use. We compared the total number of vancomycin prescriptions during this period to nonindicated prescriptions during this time period. 
Results: The rate of non-indicated vancomycin use was 4.8%. The most common non-indicated use of vancomycin was when there was no identifiable or presumed bacterial infection (36.4% of non-indicated use). The second most common reason was the organism was susceptible to a first line antibiotic (32.7%). The third most common reason was the prescription of vancomycin for community acquired pneumonia (CAP) with low a MRSA risk (29.1%).
Conclusion: 95.2% of vancomycin orders were adherent to hospital policy. Adherence to ASP guidelines reduces vancomycin misuse and promotes antibiotic de-escalation. This reduces the amount of unnecessary vancomycin use within the hospital and protects patients from unnecessary antibiotic exposure. 


Are Vancomycin Use Guidelines Followed in a Community Hospital? 
Examining Vancomycin Prescriptions Through Retrospective Chart Review

 Allergy and Immunology / Infectious Disease

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