Antibiotic cost savings from formulary restrictions and physician monitoring in a medical-school-affiliated hospital.
Strictly enforced formulary restrictions for aminoglycosides, cephalosporins, and a vancomycin group generated combined savings of $2.61 (p less than 0.0046) per antibiotic day and $34,597 (p less than 0.0003) per month. Even after some cost increases (not significant) in new and other antibiotics, the program saved $1.33 (p less than 0.0175) per antibiotic day and $24,620 (p less than 0.0311) per month for all antibiotics. The pharmacy's 1985 average cost per antibiotic day and its monthly expenditures were $18.45 and $199,003, respectively. In the months following the formulary restrictions, no significant detrimental changes occurred in hospital length of stay or mortality. A retrospective analysis of 322 patients with bacteremia treated before and after the onset of the controls revealed that antibiotics were more appropriately used afterwards.
Woodward
R S
RS
Department of Medicine, Washington University School of Medicine, St. Louis, Missouri 63110.
Medoff
G
G
Smith
M D
MD
Gray
J L
JL
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D003363:Cost Control; D003365:Costs and Cost Analysis; D004363:Drug Utilization / Q000191:economics; D005572:Formularies, Hospital as Topic / Q000191:economics*; D006746:Hospital Bed Capacity, 500 and over; D006784:Hospitals, Teaching / Q000191:economics*; D006801:Humans; D008923:Missouri; D010607:Pharmacy Service, Hospital / Q000191:economics*; D012044:Regression Analysis; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy; D014640:Vancomycin / Q000627:therapeutic use*
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D014640:Vancomycin