AN OPINION SELECTING COST-EFFECTIVE ANTIMICROBIAL PROPHYLAXIS IN SURGERY: ARE WE GETTING WHAT WE PAY FOR?

expensesassociated with the use of cefazolin or cefamandoleduring a prospective randomizedcomparison of antimicrobial prophylaxis in cardiac surgery were compared. Although the acquisitioncost and administration charges related to the use of cefamandolewere in excess of those incurred with cefazolin, differences in the charges associated with treating the wound infections that failed prophylaxis with each regimen made cefamandolethe more cost-effective prophylactic agent (mean total of $766 per cefazolin recipientvs. $315per cefamandole recipient). Analysis of prophylactic antimicrobials should include the expensesassociated with "prophylactic failures. " The agent that is least expensivefor the pharmacy may not be the most cost-effectivechoice for the institution. DICP Ann Pharmacother 1990;24:183-5. ALTHOUGH CONTROLLED CLINICAL TRIALS have establishe