A cost effective approach to surgical antibiotic prophylaxis.
Cefoxitin has been the prophylactic antibiotic of choice for appendectomy and colorectal surgery at this institution. Recent information suggests that cefazolin and metronidazole given as a single intravenous preparation could be a cost-effective alternative to cefoxitin or cefotetan for surgical antimicrobial prophylaxis of uncomplicated appendectomies. This study was conducted to determine the efficacy, toxicity, and cost of the current antibiotic regimens used for prophylaxis of uncomplicated appendectomies, to evaluate the efficacy, toxicity and cost of the cefazolin plus metronidazole combination in uncomplicated appendectomies, and to facilitate a cooperative working relationship between the Departments of Pharmacy and General Surgery. Although the numbers involved were small, this study suggests that the cefazolin/metronidazole combination is cost-effective. It is suggested that research is warranted in evaluating combinations such as this as cost-effective alternatives to current therapy.
Royal Columbian Hospital, New Westminster, British Columbia.
M M
MM
Pavan
D L
DL
Malyuk
D001062:Appendectomy / Q000009:adverse effects / Q000191:economics; D001955:British Columbia; D002437:Cefazolin / Q000191:economics / Q000627:therapeutic use*; D002440:Cefoxitin / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004359:Drug Therapy, Combination / Q000191:economics / Q000627:therapeutic use*; D005069:Evaluation Studies as Topic; D006746:Hospital Bed Capacity, 500 and over; D006801:Humans; D015274:Interdepartmental Relations; D008795:Metronidazole / Q000191:economics / Q000627:therapeutic use*; D010607:Pharmacy Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D011292:Premedication / Q000191:economics*; D011897:Random Allocation; D012107:Research Design; D013530:Surgical Wound Infection / Q000191:economics / Q000517:prevention & control*; D011795:Surveys and Questionnaires