ANTIBIOTIC PHARMACOECONOMICS - AN ATTEMPT TO FIND THE REAL COST OF HOSPITAL ANTIBIOTIC PRESCRIBING

Antibiotics account for a large part of all hospital pharmacy budgets, but the actual cost of their prescription is unknown. These costs inc lude intravenous administration, labour, serum antibiotic assay, monit oring of haematological and biochemical indices, disposal of sharps an d adverse effects. An in - house method of costing antibiotic therapy is presented, to quantify these hidden expenses. Since not only an awa reness, but an accurate quantification, of hidden costs is required, a study of various hospital procedures relating directly to antibiotic therapy was undertaken in an acute medical ward; this involved the ide ntification of particular staff members performing various procedures, consumables used and time taken. The cost of five-day courses of gent amicin, penicillin G, ampicillin, flucloxacillin, cefuroxime, ceftotax ime and erythromycin has been calculated; drug and hidden costs for ea ch are presented graphically for comparison. The breakdown cost for ge ntamicin is presented to illustrate the method. The costing of adverse effects has not been attempted. We suggest that costings of this sort are used in cost-benefit analysis of antibiotic use. These calculatio ns have been incorporated into a computer spreadsheet and this costing service will be offered to clinical areas of our hospital.