Cost savings achieved through cephalosporin use review and restriction

Attempts to control costs associated with antimicrobial therapy and surgical prophylaxis with injectable cephalosporins in a 335-bed, acute-care, county teaching hospital are described. An ABC analysis of our pharmacy inventory revealed that 11.8% of the annual pharmaceutical budget was represented by cefamandole and that this agent was used primarily for surgical prophylaxis. Initial attempts to replace cefamandole with cefuroxime met with unexpected resistance from the department of surgery and were unsuccessful. A cost analysis revealed that annual savings in supply and personnel costs of $115,819 could be realized if cefazolin were substituted for cefamandole. Substitution of cefazolin resulted in an additional cost savings of $40,000 above our original proposal involving cefuroxime. Persistent efforts of the department of pharmacy aided the effective implementation of this alteration in cephalosporin prescribing practices.