Vancomycin use in a hospital with vancomycin restriction

We evaluated vancomycin use in a hospital with endemic vancomycin-resistant enterococci and a vancomycin restriction program. Only 68% of vancomycin w as prescribed appropriately. Inappropriate use was due primarily to empiric al therapy. Ln the patients with a microbiological diagnosis following empi rical therapy, 83% (25/30) had infections due to bacteria sensitive to an a ppropriate antibiotic other than vancomycin. However, only 60% (15/25) of t hese patients had their vancomycin orders changed.