Comparison of the Effects of Prophylactic Antibiotic Therapy and Cost-effectiveness between Cefazolin (CEZ) and Sulbactam/Ampicillin (SBT/ABPC) in Gastric Cancer Surgery Employing Clinical Pathway

• Published in: YAKUGAKU ZASSHI Vol. 124; no. 11; pp. 815 - 824
• Main Authors: ISE, Yuya, HAGIWARA, Ken, SAITOH, Setsuo, HONJO, Kazuyoshi, SOH, Shizuka, KATO, Ayumi, KATAYAMA, Shirou, NISHIZAWA, Kenji, HIRANO, Masaaki, YOSHIYUKI, Toshiro, KIYAMA, Teruo, MITSUHASHI, Kyoko, KAMEI, Miwako, SHIRAGAMI, Makoto
• Format: Journal Article
• Language: English; Japanese
• Published: Japan The Pharmaceutical Society of Japan 01-11-2004
• Subjects: Aged; Ampicillin - economics; Ampicillin - therapeutic use; Antibiotic Prophylaxis - economics; Cefazolin (CEZ); Cefazolin - economics; Cefazolin - therapeutic use; clinical pathway; Cost-Benefit Analysis; cost-effective analysis; Critical Pathways; Female; Gastrectomy; gastric cancer; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - prevention & control; Humans; Male; Middle Aged; Postoperative Complications - microbiology; Postoperative Complications - prevention & control; prophylactic antibiotic therapy; Retrospective Studies; Stomach Neoplasms - surgery; Sulbactam - economics; Sulbactam - therapeutic use; Sulbactam/Ampicillin (SBT/ABPC)
• ISSN: 0031-6903; 1347-5231
• DOI: 10.1248/yakushi.124.815

The present study was designed to investigate the effects of prophylactic antibiotic therapy and the cost-effectiveness of Cefazolin (CEZ) and Sulbactam/Ampicillin (SBT/ABPC) in gastric cancer surgery employing clinical pathway. 157 patients (62 in the CEZ group and 95 in the SBT/ABPC group), who underwent surgery for gastric cancer at the First Department of Surgery of our hospital, were investigated. There was no significant difference between the groups with regard to sex, age, incidence of complication, stage of cancer, surgical method, operative time and blood loss, length of hospitalization, the appearance of systemic inflammatory response syndrome (SIRS), changes body tempreture, white blood cell count (WBC), C-reactive protein (CRP), or clinical outcome of postoperative care by a nurse during post-operation for 7 days. The prophylactic effect of infection was also no different between the CEZ (69.4%) and SBT/ABPC (69.5%) groups. In contrast, decision analysis strongly indicated that the anticipate cost of antibiotics was higher in the latter group (¥20402) than in the CEZ group (¥15556), suggesting that the prophylactic effect of CEZ may be more cost-effective. Thus, evaluations of pharmacotherapy from the aspect of cost may be one of the important responsibility of hospital pharmacists in the future.