Effectiveness of an antibiotic cost containment measure.

University Hospital, University of British Columbia (UBC) Site, a 600-bed teaching hospital in Vancouver, British Columbia, adopted several cost containment measures on August 2, 1988 in an attempt to limit the rise in antibiotic expenditures. One cost containment measure involved extending the dosing intervals of cefazolin, clindamycin and metronidazole by a pharmacy-based automatic dosing interval interchange. Cefazolin and clindamycin orders were changed to an every eight-hour dosing schedule, and metronidazole orders to an every 12-hour schedule. Data were retrospectively collected and tabulated from August 1987 to February 1988 (pre-implementation or PRE period) and August 1988 to February 1989 (post-implementation or POST period). During the POST period, the mean doses per course were significantly less for metronidazole. Estimated cost savings from the measure was $7,300 for the seven-month POST period. Annualized, the expected savings would be $12,600, which is 4.4% of 1988/1989 total antibiotic expenditures. This cost containment strategy achieved its goal of effective cost savings for University Hospital, UBC Site. Although a small reduction in total drug budget was seen, this study suggests that savings can be achieved through this cost containment measure.