A drug utilization review identified significant inappropriate use of second-generation cephalosporins at a 700-bed community teaching hospital. As a result, an educational program designed to modify physician prescribing patterns was developed as a cost-containment measure. Educational guidelines listing indications and contraindications for cefamandole and cefoxitin and comparing their costs with those of first-generation cephalosporins were placed in patient records, and physician use of these agents was reviewed before, during, and after the intervention. The rate of combined appropriate use of cefamandole and cefoxitin increased from 30 to 58% during the study. A change from the second-generation cephalosporins to therapeutically equivalent, less-expensive drugs was noted in 28% of patients' medical records within 48 hours after placement of the guidelines. This educational program proved to be a low-cost method of successfully altering the prescribing patterns of physicians.
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