Multidisciplinary approach to cost reduction of C-section prophylaxis

Runaway cefoxitin costs prompted a thorough usage evaluation by the P & T Committee, the antibiotic review subcommittee, and the pharmacy department at this 450-bed teaching hospital. C-section prophylaxis accounted for 25% of all cefoxitin usage. With the assistance of the ob/gyn department, a major campaign was initiated to alter prescribing habits and evaluate more cost effective prophylaxis. Single dose cefotetan replaced multidose cefoxitin regimen for a 6-month trial basis. Annualized cost savings for drug and supplies were approximately $49,086, and no change in morbidity was noted. The ob/gyn department then agreed, at the request of the antibiotic subcommittee, to conduct a trial comparing single dose cefotetan with single dose cefazolin in women undergoing C-section. The results indicated that both treatments were equally effective, consequently, cefazolin replaced cefotetan, producing an additional $10,384 annual savings. Overall, our approach to C-section cost reduction resulted in a total of $59,470 annual savings and demonstrated the effectiveness of an organized multidisciplinary approach.