Predisposing factors of phlebitis in children treated with vancomycin

Considering widespread use of vancomycin in childeren and the occurrence of phlebitis related peripheral intravenous catheters (PIVC); we decided to determine Predisposing factorsof phlebitis in the childeren receiving vancomycin.

Methods and Materials: 

This cross-sectional descriptive-analytic study included 145 children older than 1 month who had been admitted to a medical education center in Isfahan and were under treatment with vancomycin. The sampling method was convenience and phlebitis measuring instruments were used 24, 48 and 72 hours, after the peripheral intravenous catheter insertion for every child. Chi-square test and multinomial logistic regression tests were used to analyze the data.

Chi-Square test showed a significant relationship between phlebitis and catheter place, catheter size and washing catheter with 0.09%NaCl (p<0.05). Multinomial logistic regression indicated that age (p=0.009), male gender (p=0.009), catheter placement in upper extremity (p=0.005), catheter No.24 (p=0.04), washing catheter with 0.09%NaCl (p<0.001), vancomycin concentration of <5mg/ml (p=0.004) and infusion of total peripheral nutrition (p=0.017) and cephalosporins (p=0.025) significantly influenced incidence of phlebitis.

nurses can prevent phlebitis by selecting appropriate catheter considering the ratio of catheter to vein size, washing catheter with 0.09%NaCl and use of the upper extremities for catheter insertion. The concentration of vancomycin should also be <5 mg/ml and the infusion rate should not exceed 5-10 mg/min. These factors have considerable importance when childeren receive total peripheral nutrition and cephalosporins along with vancomycin