Cost analysis of cefmetazole versus cefoxitin in the treatment of penetrating abdominal trauma

Abstract

Cefmetazole is a new cephamycin antibiotic with a microbiologic spectrum very similar to cefoxitin. Because of its longer half-life, cefmetazole can be dosed on an every 8 hour schedule, in contrast to cefoxitin, which is usually dosed every 6 hours. The objective of this study was to determine the cost effectiveness of cefmetazole 2 gm via intravenous piggyback (IVPB) every 8 hours versus cefoxitin 2 gm IVPB every six hours in patients with perforated viscous secondary to abdominal trauma. Sixty-seven patients between 17 and 56 years of age were randomly assigned to receive either cefmetazole 2 gm IVPB every 8 hours or cefoxitin 2 gm IVPB every 6 hours in this prospective trial. The failure rate was not statistically significantly different between the two groups, with 4 of 36 patients in the cefmetazole group and 8 of 31 patients in the cefoxitin group ( P = 0.1178) designated as failures. The mean drug acquisition costs for each admission in the cefmetazole and cefoxitin groups were $203.10 and $322.09, respectively, and were significantly higher for the cefoxitin group ( P < 0.0005). There were significantly higher costs associated with the cefoxitin group for IVPB supply costs ($21.30), nursing ($22.00), pharmacy technician ($6.28), and pharmacist ($1.10) costs, as opposed to the cefmetazole group ($16.48, $17.02, $4.85, and $0.85, respectively). We found the use of cefmetazole in patients with intra-abdominal infections to be a cost-effective alternative to cefoxitin, resulting in significant savings in labor and material costs.