Table 1 Characteristics of studies included in the systematic review
Study | Setting | Study population | VRE at institution | Study design | Intervention(s) | Length of follow up | Vancomycin use outcome | VRE outcome |
|---|---|---|---|---|---|---|---|---|
[26] | Children's hospital | Pediatric oncology and ICU | Initial cases | A2†| VR + IC | 5 mos. | Proportion of patients receiving | Prevalence of colonization |
[20] | Academic hospital | General inpatient | Endemic | A2†| IC → VR | 6 mos. | PO and IV doses/mo. | Prevalence of colonization |
[27] | VA hospital | General inpatient | Outbreak | 1)A1 2)A2†| IC→ restrict vanco, ceftazidime and clindamycin | 6 mos. | PO and IV units/mo. | Prevalence of colonization, incidence of positive clinical isolates |
[28] | Academic hospital | "High risk ward" | Outbreak | A1* | VR + IC | 4 mos. | % of orders inappropriate per HICPAC, grams/1,000 pt-days | Incidence of positive surveillance cultures |
[29] | Academic hospital | General inpatient | Endemic | A1 | VR | 24 mos. | Grams/1,000 pt-days, total # of patients exposed | Incidence as % of all enterococcal isolates resistant to vanco |
[30] | Non-teaching community hospital | General inpatient | Endemic | A2†| Vanco education program → VR | 24 mos. | Doses purchased/1,000 pt-days, dollar purchases/1,000 pt-days, empiric treatment, treatment with positive culture | Incidence of colonization or infection (quarterly) |
[31] | ICUs of an academic hospital | ICU | Endemic with super-imposed outbreaks | A2†| IC + progressive VR | 19 mos. | Doses/1,000 pt-days | Incidence of colonization and infection (monthly) |
[32] | Academic oncology ward | Oncology | Endemic | A1 | IC→ enhanced IC (included efforts to reduce use of all antimicrobials) + VR | 12 mos. | Grams/1,000 pt-days | Incidence of colonization/1,000 pt-days and BSI/1,000 pt-days |
[33] | Academic cancer center's BMT and leukemia ward | Heme malignancy | Endemic | A1* | VR + IC | 36 mos. | Empiric use in grams/1,000 pt-days Cost/1,000 pt-days | Incidence of total infections/1,000 pt-days and BSI/1,000 pt-days |
[34] | 50 ICU's at 20 hospitals; academic, VA and community | ICU | Not reported | A1 | Vanco use local monitoring data compared with national benchmarks | 23 mos. | DDD/1,000 pt-days | Prevalence of positive clinical isolates |
[35] | Academic hospital | General inpatient | Endemic | A1* | Progressive VR | 4 yrs. | DDD/1,000 pt-days | Prevalence as annual % of enterococcal isolates resistant to vanco |
[36] | Academic hospital | General inpatient | Endemic | A1 | VR | 8 yrs | % of orders inappropriate per HICPAC guidelines; grams/1,000 pt-days | Incidence: infections/yr |
[36] | ICU | ICU | Endemic | A1* | Multidisciplinary ICU team to reduce vanco use | 4 yrs. | % of orders inappropriate per HICPAC guidelines | Incidence: infections/yr, infections/1,000 pt-days |