While vancomycin has been used for nearly 60 years, it remains the principal treatment for infection caused by serious Gram-positive bacteria such as methicillin-resistant
Staphylococcus aureus (MRSA) [
1]. Vancomycin, unlike many other antibiotics, has a number of special considerations, such as the requirement for individualization of dosing and serum drug monitoring to ensure efficacy, minimize toxicity and limit the development of bacterial resistance [
2‐
4]. These factors, in addition to increasing concerns about antimicrobial resistance [
5,
6] and the need to prolong the life of our existing antibiotics, have led to the publication of a number of vancomycin guidelines [
7], including important national guidelines for the dosing and or monitoring of vancomycin from the United States (US), Japan and China [
8‐
10]. Significant effort and resources are invested in the process and preparation of such high-quality national guidelines, which are endorsed by peak professional societies in their respective countries [
11,
12]. These documents provide much needed contemporary guidance on the appropriate use of vancomycin; however, there is a paucity of information about how these vancomycin guidelines and their contents should be best disseminated and implemented into practice to achieve the intended outcomes for clinicians and patients. Only one guideline, by the Chinese Pharmacological Society [
10], includes some information about implementation. The implementation details associated with this guideline propose promotion via conferences, education sessions for physicians, pharmacists and nurses, and research to evaluate both the implementation and impact of the guideline on vancomycin therapeutic drug monitoring (TDM) [
13].
There are numerous reports in the medical literature that highlight clinicians lack of knowledge of the contents of key guidelines in addition to an often low uptake of guidelines [
14‐
16]. To combat this issue, adoption strategies have been recommended by a number of prominent organizational developers of guidelines such as the Australian National Health and Medical Research Council (NHMRC) [
17,
18], the United Kingdom’s National Institute for Health and Clinical Excellence (NICE) [
19], the Scottish Intercollegiate Guideline Network (SIGN) [
20], and the US Institute of Medicine (IOM) [
21]. While it is prudent that any plan to implement a guideline or practice change should include an assessment of the barriers and enablers [
22], there are common implementation strategies recommended by these organizations, which are widely employed. Such strategies include the provision of education about the guideline and its recommendations [
23]. Educational meetings have demonstrated changes in practice measures between 1.8% and 15.9% [
24], while dissemination of guidelines and educational supporting material have been shown to have a median 8.1% improvement on care [
25], although there have been recent concerns about the effectiveness of the latter [
26]. Determination of the relative effectiveness of these strategies to promote the implementation of guidelines or practice change initiatives for vancomycin is important to prudently allocate supportive resources. While a systematic review on guidelines for TDM of vancomycin has been published [
7], the current review aims to identify and evaluate the effect of interventions employing education, guideline implementation and dissemination of educational resources on the therapeutic drug monitoring and dosing of vancomycin.