AN ASSESSMENT OF THE HIDDEN AND TOTAL ANTIBIOTIC COSTS OF 4 PARENTERAL CEPHALOSPORINS

The aim of this study was to compare the hidden costs, and their impac t on total antibiotic costs, of ceftriaxone therapy with those of cefo taxime, ceftazidime and cefuroxime in nosocomial infection. The total antibiotic costs of 7-day standard courses of the 4 cephalosporins wer e compared. The costs were divided into 3 parts: (i) the cost of the d rug itself; (ii) the preparation and administration (labour) costs; an d (iii) the consumables and waste costs. The latter 2 costs together c omprised the hidden cost of an antibiotic course. Hidden costs were hi gher for cefotaxime, ceftazidime and cefuroxime, which are normally ad ministered 3 times a day, than for ceftriaxone, which is administered once daily. The percentage contribution of hidden costs to total antib iotic costs increased with decreasing antibiotic cast, and were lower with higher dosages of all antibiotics. With cefotaxime, ceftazidime a nd cefuroxime, and with ceftriaxone at the lower dosage given by bolus intravenous (IV) injection, the labour component of hidden costs exce eded the consumables/waste component. However, when costs were calcula ted for ceftriaxone administered at the higher dosage by IV infusion, the costs of consumables and waste were greater than the labour costs. Ceftriaxone had the lowest hidden costs of all the antibiotics studie d. The total antibiotic cost of low dosage ceftriaxone (1g per dose) w as comparable with that of cefuroxime, and was substantially less than the costs of cefotaxime and ceftazidime. At the high ceftriaxone dosa ge (2g per dose), the total antibiotic cost of cefuroxime was less tha n that of ceftriaxone; however, the total antibiotic cost of ceftriaxo ne remained substantially less than that of cefotaxime or ceftazidime.