Cephalosporin selection: view from a beleaguered P & T committee member

Formulary decisions in smaller community hospitals are often not made with the same criteria used in large university medical centers. Community hospitals do not have the diagnostic technologies of the tertiary medical centers, nor do they experience the wide variety of bacterial infections. When the P & T Committees of such hospitals make formulary decisions regarding cephalosporins, they must base these choices on their particular needs, such as breadth of coverage and cost-effectiveness. A P & T Committee member from a community hospital offers his views on appropriate cephalosporin selection.