Medication use evaluation of oral vancomycin prescribing for treatment of Clostridioides difficile infection in a university hospital

Abstract

The rising incidence of Clostridioides difficile infection (CDI) necessitates the appropriate use of oral vancomycin, the first line treatment, to ensure optimal clinical outcomes and promote rational drug use. The objective of this research is to investigate patient characteristics, oral vancomycin prescribing patterns, appropriateness of medication use, and clinical outcomes of this infection. Methods: This retrospective descriptive study was conducted with patients receiving oral vancomycin at Srinagarind Hospital during the 2025 fiscal year. Data was retrieved from electronic databases and categorized based on laboratory results, appropriateness of drug use, and treatment outcomes. Data were analyzed using descriptive statistics, and inferential statistics were used to compare differences between groups. Results: A total of 145 patients met the inclusion criteria. The majority were male (60.7%), aged over 65 years (49.0%), and had underlying diseases (95.9%). There were 154 treatment episodes in total, most of which were initial infections (92.9%) and non-severe cases (39.0%). Among the 99 treatment episodes where therapy was indicated, the overall appropriateness of drug use across all domains was 52.5%. Regarding clinical outcomes, most patients showed a reduction in body temperature (90.5%) and stool frequency (62.9%). No significant differences in treatment outcomes were observed when categorized by laboratory results or appropriateness of drug use. Conclusion: Although oral vancomycin use was appropriate in all domains, only 52.5% of cases, clinical outcomes remained favorable. There were no significant differences in outcomes across infection categories. Nevertheless, further development of medication management protocols is recommended to enhance the rational use of medicines.