Cost containment of the second-generation cephalosporins by prospective monitoring at a community teaching hospital.
All patients receiving cefoxitin and cefamandole were prospectively reviewed for appropriate and inappropriate utilization. There were two eight-week survey periods. In period 1, 81 (70%) of 115 patients received cefoxitin appropriately and six (40%) of 15 patients received cefamandole appropriately. In patients receiving antibiotics inappropriately, 12 (35%) of the 34 receiving cefoxitin and eight (89%) of the nine receiving cefamandole had infections that could have been treated with less expensive, equally efficacious antibiotics. Changes in antibiotic therapy were made in 79% of patients based on our recommendations. The estimated annual cost saving for these antibiotics was $40,290. During period 2, 73 (91%) of 80 patients were given cefoxitin appropriately and 14 (61%) of 23 patients received cefamandole appropriately. Forty-three percent of those receiving cefoxitin and 33% of those receiving cefamandole inappropriately could have been treated with a less expensive, equally efficacious antibiotic. In 88% of patients, the attending physicians followed our recommendations.
D001424:Bacterial Infections / Q000188:drug therapy / Q000191:economics*; D002435:Cefamandole / Q000627:therapeutic use*; D002440:Cefoxitin / Q000627:therapeutic use*; D003363:Cost Control; D004363:Drug Utilization / Q000191:economics; D006764:Hospitals, Community / Q000191:economics; D006784:Hospitals, Teaching / Q000191:economics; D006801:Humans; D009515:New Jersey; D011446:Prospective Studies
D002435:Cefamandole; D002440:Cefoxitin