Cephalosporins: use review and cost analysis

Area of Science:

• Pharmacoeconomics
• Infectious Diseases
• Hospital Pharmacy

Background:

• Parenteral cephalosporins are widely used in hospitals.
• Formulary restrictions and drug approval processes impact prescribing patterns and costs.
• Cephalothin sodium and cefazolin sodium are common parenteral cephalosporins.

Purpose of the Study:

• To evaluate the impact of restricting cephalothin sodium and approving cefazolin sodium on prescribing patterns and costs.
• To analyze the cost-effectiveness of switching to cefazolin sodium as the primary parenteral cephalosporin.
• To assess the appropriateness of cefazolin sodium use in a university hospital setting.

Main Methods:

• A three-year retrospective analysis of parenteral cephalosporin use and costs.
• A one-month prospective study of cefazolin sodium prescribing patterns (dose, frequency, duration, indications) in 64 patients.
• Comparison of cost expenditures before and after the formulary change.

Main Results:

• The switch from cephalothin sodium to cefazolin sodium resulted in projected annual savings of $5,500.
• This represented over 10% of the hospital's total parenteral cephalosporin expenditures.
• The prescribed daily dose of cephalosporins decreased by one-third post-formulary change.
• Cefazolin sodium use was generally appropriate, with the main misuse identified in postsurgical prophylactic therapy.

Conclusions:

• The formulary decision to prioritize cefazolin sodium led to significant cost savings.
• Appropriate drug selection and formulary management are crucial for optimizing antibiotic expenditures.
• Further education on appropriate prophylactic use of cefazolin sodium may be warranted.