Survey Finds Major Gaps in Vancomycin Knowledge Among Chinese Healthcare Professionals

Vancomycin remains one of the most important antibiotics for treating serious Gram-positive infections, but its narrow therapeutic window means that clinicians must carefully balance efficacy against toxicity, typically guided by therapeutic drug monitoring (TDM). A new multicenter cross-sectional survey published in BMC Health Services Research suggests that many healthcare professionals in China lack key knowledge about the drug and its monitoring, and that institutional capacity for TDM is far from universal.

The study used a structured electronic questionnaire distributed to healthcare professionals involved in clinical or pharmaceutical care across multiple regions of China. The instrument covered four domains: demographic characteristics, basic knowledge of vancomycin, cognition and self-reported practice behaviors related to TDM, and self-assessment of familiarity together with training needs. Descriptive statistics and group comparisons were used to evaluate differences among professional groups.

A total of 400 valid questionnaires were included in the analysis. Respondents comprised 127 physicians (31.8%), 243 pharmacists (60.8%), and 30 nurses (7.5%), giving the results a strong pharmacy weighting that readers should keep in mind when interpreting group comparisons.

Knowledge scores revealed substantial gaps. The mean score on the 10-item basic knowledge section was 57.10 ± 14.51, with statistically significant differences across professional groups (P < 0.001). Pharmacists achieved the highest mean scores at 61.07 ± 13.04, while nurses scored lowest at 47.33 ± 13.11. These figures describe a self-reported survey sample and cannot by themselves establish how knowledge translates into prescribing quality or patient outcomes.

The pattern of correct answers was particularly striking. While 93.8% of respondents correctly identified the populations requiring vancomycin concentration monitoring, only 6.0% answered correctly about monitoring indicators, and just 7.0% knew the appropriate timing of first monitoring in patients with normal renal function. In other words, professionals broadly recognized who should be monitored but largely did not know what to monitor or when to begin.

Access to monitoring services also emerged as a constraint. Only 46.5% of respondents reported that vancomycin concentration monitoring was available in their institutions, meaning that even knowledgeable practitioners in half of the represented settings may face structural barriers to implementing TDM as guidelines intend.

The survey also probed self-assessed familiarity. After reading explanatory content included in the questionnaire, participants reported higher self-rated familiarity with vancomycin-related knowledge, with scores rising from 3.39 ± 0.93 to 3.85 ± 0.85 (P < 0.001). The authors are careful to note that this shift reflects perceived familiarity rather than an objectively measured improvement in knowledge, an important distinction given how briefly the explanatory material was presented.

Demand for education was nearly universal: 96.5% of respondents considered training on vancomycin use necessary. Combined with the observed variation across professional groups, this points toward profession-specific, tiered, and targeted training strategies rather than a single generic curriculum, alongside stronger institutional support for TDM services.

The authors conclude that healthcare professionals in multiple regions of China showed important knowledge gaps regarding vancomycin use, particularly in TDM implementation, and suggest that strengthening education and institutional support may promote more rational use of the antibiotic and improve medication safety. As a cross-sectional, self-reported survey, the study captures knowledge and perceptions at a single point in time and cannot demonstrate causal effects of training on practice; nevertheless, the low correct-response rates on monitoring indicators and timing, together with limited institutional monitoring availability, offer a concrete baseline for designing and evaluating future interventions.

Subject of Research: Knowledge, TDM-related practices, and training needs regarding clinical vancomycin use among healthcare professionals in China

Article Title: Knowledge, TDM-related practices, and training needs regarding the clinical use of vancomycin among healthcare professionals in China: a cross-sectional survey

Article References: Chen, S., Li, J., Zhou, Y., Cao, C., Lv, Q., Li, X., & Pan, K. (2026). Knowledge, TDM-related practices, and training needs regarding the clinical use of vancomycin among healthcare professionals in China: a cross-sectional survey. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15502-1

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15502-1

Keywords: vancomycin, therapeutic drug monitoring, cross-sectional survey, China, healthcare professionals, antibiotic stewardship, knowledge gaps, pharmacists, medication safety, training needs, Knowledge, TDM-related