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Ceftazidime dosing in the elderly: economic implications

P H Vlasses1, W A Bastion, R Behal

  • 1University Hospital Consortium, Technology Advancement Center, Oak Brook, IL 60521.

The Annals of Pharmacotherapy
|July 1, 1993
PubMed
Summary
This summary is machine-generated.

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Elderly patients often receive excessive ceftazidime (a beta-lactam antibiotic) doses due to unconsidered renal function. Adjusting ceftazidime dosage based on creatinine clearance can prevent unnecessary costs in hospitalized older adults.

Area of Science:

  • Pharmacology
  • Nephrology
  • Geriatrics

Background:

  • Ceftazidime, a beta-lactam antibiotic, is primarily eliminated by glomerular filtration.
  • Renal function, specifically glomerular filtration, typically declines with age, necessitating dose adjustments in elderly patients.
  • Product labeling for ceftazidime often recommends dose reductions in the elderly, but this is not always followed.

Purpose of the Study:

  • To determine the prevalence of ceftazidime dosing exceeding product labeling recommendations in elderly hospitalized patients.
  • To evaluate the financial costs associated with inappropriate ceftazidime dosing in this population.

Main Methods:

  • A multicenter, retrospective audit of 221 medical records of patients aged 65 and older who received ceftazidime.
  • Creatinine clearance was estimated using the Cockcroft-Gault formula for all included patients.

Related Experiment Videos

  • Dosing appropriateness was compared against product labeling recommendations.

    • Main Results:

    • Half of the elderly patients (50%) exhibited renal insufficiency (creatinine clearance < 50 mL/min).
    • Among patients with renal insufficiency, 68% received ceftazidime doses exceeding labeling recommendations.
    • The estimated cost of this excess dosing was $13,822.50 across 75 patients.

    Conclusions:

    • Ceftazidime is frequently overdosed in elderly patients because renal function is not adequately assessed.
    • Implementing ceftazidime dose adjustments based on estimated creatinine clearance can result in significant cost savings for healthcare institutions.
    • These cost savings are particularly relevant in the US healthcare system where Medicare reimbursement is diagnosis-based.