Surgical Antibiotic Prophylaxis, Patient Morbidity, and Cost Reduction: A Three-Year Study

Abstract

Twenty-five to 50 percent of all antibiotics prescribed for hospitalized patients are for prevention, not treatment, of infection. Procedures to institute rational, cost-effective utilization of these agents should have a significant impact on drug cost and pharmacy inventory. Several authors have described antibiotic cost reduction programs using pharmacy intervention. Unfortunately, measures that are successful in one institution may not be effective or appropriate in another. A three-year study was undertaken to examine the impact on physician prescribing of an infection control bulletin and formalized recommendation for antibiotic utilization. Patient records also were examined to determine if any change in antibiotic utilization would influence patient morbidity. Over the three examination periods there was a significant reduction in cost of prophylaxis in 7 surgical groups, and a trend toward cost reduction in 21 additional groups. Cost of prophylaxis also increased in other surgical groups. Cost reduction was associated with limited duration of prophylaxis and a shift toward use of first generation cephalosporin products. Patient morbidity did not differ significantly.

Antimicrobial prophylaxis in colorectal surgery: a systematic review of randomised controlled trials.

“…It is possible to reduce the cost of antibiotic prophylaxis without adversely affecting SWI rate. [177][178][179][180][181] For example, where appropriate:…”

Antimicrobial prophylaxis in colorectal surgery

“…61 62 It may be possible to reduce the cost of antibiotic prophylaxis without adversely aVecting surgical wound infection rate. [63][64][65][66][67] This can be done, for example, by single dose or short term use (less than 24 hours after operation) instead of inappropriate long term use of antibiotics, and by using more eVective and less costly drugs and routes of administration.…”