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December 21, 1984

Cost-Effectiveness of Antibiotic Use

Author Affiliations

C. J. Harris Community Hospital Sylva, NC

JAMA. 1984;252(23):3252. doi:10.1001/jama.1984.03350230014014

To the Editor.—  Recently, we completed an analysis of cost-effectiveness of antibiotic use in our 80-bed rural hospital. From all admissions in an arbitrarily selected month (381 admissions in September 1982), a high-cost antibiotic usage group was selected. This was defined as all patients for whom the cost of antibiotics was more than 1 SD above the group mean for all patients receiving antibiotics.Of 169 patients receiving antibiotics, 38 patients were in this high-cost group. These patients' records were then reviewed to see whether a less expensive but equally effective antibiotic (or combination of antibiotics) could have been used. Using conservative criteria,1 16 cases were identified for which a less expensive antibiotic could have been used. In many of these cases, the cheaper antibiotic was distinctly preferable to the one actually used (eg, use of penicillin instead of cefamandole for pneumococcal pneumonia proven by Gram's stain and culture).