Antibiotic cost savings from formulary restrictions and physician monitoring in a medical-school-affiliated hospital.

Robert Woodward, University of New Hampshire - Main Campus
Gerald Medoff, Washington University School of Medicine in St. Louis
Marc D. Smith, Washington University School of Medicine in St. Louis
James L. Gray III, Washington University School of Medicine in St. Louis

Abstract

Abstract

Strictly enforced antibiotic formulary restrictions for aminoglycosides, cephalosporins, and a vancomycin group generated combined savings of $2.61 (p <0.0046) per antibiotic day and $34,597 (p <0.0003) per month. Even after some cost increases (not significant) in new and other antibiotics, the program saved $1.33 (p <0.0175) per antibiotic day and $24,620 (p <0.0311) per month for all antibiotics. The pharmacy's 1985 average cost per antibiotic day and its monthly expenditures were $18.45 and $199,003, respectively. In the months following the formulary restrictions, no significant detrimental changes occurred in hospital length of stay or mortality. A retrospective analysis of 322 patients with bacteremia treated before and after the onset of the controls revealed that antibiotics were more appropriately used afterwards.