Impact of Targeted Antibiotic Restriction on Usage and Cost in a Community Hospital

Abstract

Objective:

To determine whether antibiotic restriction can produce savings.

Design:

Cost comparative analysis before and after antibiotic control.

Methods:

Cost control policy included removal of nonessential antibiotics from the emergency department and the operating room, the use of a clinical pathway protocol for pneumonia, and approval from the infectious disease consultant for certain high-cost antibiotics.

Setting:

Lutheran Medical Center, a community hospital in Brooklyn, New York.

Results:

Between the two 12-month periods analyzed (March 1995-February 1996 vs. March 1996-February 1997), we found a cost reduction of approximately 26% among intravenous antibiotics with a concomitant 10% cost reduction in oral antibiotics. Intravenous antibiotic use decreased by more than 22%, especially with regard to higher priced agents. Furthermore, we documented a 24% reduction in cost per patient. Hospital admission rates declined only 2.5% during the second 12-month period.

Conclusions:

Appropriate restriction of antibiotics can be done effectively and simply in a local hospital with no additional funding and achieve considerable cost savings.