Pharmacy-laboratory interactions: a unique method to control antibiotic costs

Because a large percentage of hospital antibiotic use is regarded as inappropriate, hospital pharmacists must investigate ways of decreasing such usage. A unique approach was evaluated for its impact on cost-effective antibiotic therapy. By functioning as a team, the pharmacy and laboratory departments implemented the following steps: cost-code index on antimicrobial susceptibility and organism identification reports; suppression of cost-ineffective antibiotics within the same pharmacologic group from the antimicrobial susceptibility reports; design of minimum inhibitory concentration panels to conform to the hospital formulary; daily delivery of the antimicrobial susceptibility reports to the pharmacy. Of the 1078 documented therapeutic interventions by the clinical pharmacist, 100 were randomly selected for review, 62% of which involved direct interaction with the laboratory. Estimated cost savings due to these interactions were $8214; annual savings were $88,554. The results of this study show the importance of pharmacy departments forming and maintaining lines of communication with the hospital laboratory department.