November 1985

Cost Containment of the Second-Generation Cephalosporins by Prospective Monitoring at a Community Teaching Hospital

Author Affiliations

From the Department of Internal Medicine, Hackensack (NJ) Medical Center (Dr Williams, Gross, and Levine), and New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark (Drs Gross and Levine).

Arch Intern Med. 1985;145(11):1978-1981. doi:10.1001/archinte.1985.00360110048013

• 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.

(Arch Intern Med 1985;145:1978-1981)