Table 1.

Criteria for appropriate vancomycin use according to the CDC criteria [4]

Appropriate use

Serious infections caused by b-lactam-resistant Gram-positive microorganisms;

Infection caused by Gram-positive organisms in patients allergic to b-lactam antimicrobials;

Antibiotics treatment for colitis when there is a problem with metronidazole use or imminent life risk;

Surgical prophylaxis, with prosthesis implant, in institutions with high rates of oxacillin-resistant Gram-positive infections;

Neutropenics with extensive mucosite, infection related to venous catheters, previous prophylaxis with fluorquinolone, hypotension or sepsis.

Inappropriate use:

Routine surgical prophylaxis;

Febrile neutropenia that does not present isolation of oxacillin-resistant Gram-positive bacteria;

Treatment of a single blood culture for oxacillin-resistant Staphylococcus, coagulase-negative, if another culture collected simultaneously was sterile;

Empirical use, continuous, in patients whose cultures are negative for Gram-positive bacteria;

Presence of catheter and fever;

Decontamination of the gastrointestinal tract;

Prophylaxis for low birth weight infants;

Primary treatment of colitis by antibiotics;

Colonization by oxacillin-resistant Gram-positive bacteria;

Prophylaxis for patients in continuous peritoneal dialysis or hemodialysis;

Convenience treatment of infections by b-lactam-sensitive Gram-positive in hemodialysis patients;

Topical vancomycin use.