Controlling moxalactam and cefotaxime use with a target drug program

Area of Science:

• Pharmacoeconomics
• Infectious Diseases
• Clinical Pharmacy

Background:

• Rising healthcare costs necessitate strategies to optimize antibiotic utilization.
• Inappropriate prescribing of broad-spectrum cephalosporins, such as moxalactam and cefotaxime, contributes to increased drug expenditures.
• Third-generation cephalosporins are often overused when narrower-spectrum agents like cefazolin are clinically appropriate.

Purpose of the Study:

• To evaluate the cost-saving impact of a target drug program implemented by clinical pharmacists.
• To assess the effectiveness of pharmacist interventions in reducing the inappropriate use of moxalactam and cefotaxime.
• To quantify the financial savings achieved by promoting the substitution of cefazolin for third-generation cephalosporins.

Main Methods:

• A target drug program involved pharmacists consulting with physicians on cephalosporin prescriptions.
• Data on cephalosporin use, including piggyback doses and quarterly purchases, were systematically collected.
• Cost analysis was performed by comparing actual third-generation cephalosporin usage against predicted levels without the intervention.

Main Results:

• Moxalactam and cefotaxime use averaged 3.2% of total cephalosporin consumption, costing $4109 monthly.
• The intervention prevented an expected usage of 20% to 40% for these third-generation agents.
• Annual cost savings ranged from $91,071 to $202,815, depending on usage levels.

Conclusions:

• Clinical pharmacists play a crucial role in controlling pharmaceutical costs through targeted interventions.
• The implemented program successfully curbed inappropriate use of moxalactam and cefotaxime, leading to substantial cost reductions.
• Pharmacist-led drug stewardship programs are effective in optimizing antibiotic prescribing and managing healthcare expenses.