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

Vancomycin remains a key agent for treating serious Gram-positive infections, but its clinical use is complicated by a narrow therapeutic window and the need for therapeutic drug monitoring (TDM). Inadequate knowledge and inconsistent TDM implementation may compromise treatment effectiveness and patient safety. This study assessed knowledge regarding vancomycin use, TDM-related cognition and self-reported practice behaviors, and training needs among healthcare professionals in multiple regions of China. We conducted a multicenter cross-sectional survey using a structured electronic questionnaire among healthcare professionals involved in clinical or pharmaceutical care across multiple regions of China. The questionnaire covered four domains: demographic characteristics, basic knowledge of vancomycin, cognition and self-reported practice behaviors related to TDM, and self-assessment and training needs. Descriptive statistics and group comparisons were used to evaluate differences among professional groups. A total of 400 valid questionnaires were included, comprising 127 physicians (31.8%), 243 pharmacists (60.8%), and 30 nurses (7.5%). The mean score for the 10-item basic knowledge section was 57.10 ± 14.51, with significant differences across professional groups ( P < 0.001); pharmacists achieved the highest scores (61.07 ± 13.04), whereas nurses had the lowest (47.33 ± 13.11). Although the correct response rate was high for identifying populations requiring vancomycin concentration monitoring (93.8%), it was markedly low for monitoring indicators (6.0%) and timing of first monitoring in patients with normal renal function (7.0%). Only 46.5% of respondents reported that vancomycin concentration monitoring was available in their institutions. After reading the explanatory content in the questionnaire, participants reported a higher self-rated familiarity with vancomycin-related knowledge (3.85 ± 0.85 vs. 3.39 ± 0.93, P < 0.001), reflecting perceived familiarity rather than objectively measured improvement in knowledge. Overall, 96.5% of respondents considered training on vancomycin use necessary. Healthcare professionals in multiple regions of China showed important knowledge gaps regarding vancomycin use, particularly in TDM implementation. Variation across professional groups and limited institutional monitoring availability suggest the need for profession-specific, tiered, and targeted training strategies. Strengthening education and institutional support for vancomycin TDM may promote more rational use and improve medication safety. Not applicable.