Cost of antibiotic prophylaxis in cesarean section.

Two hundred sixty-three patients were randomly assigned to receive either piperacillin or cefoxitin for prophylaxis in cesarean section. Although both drugs were considered effective, piperacillin achieved a level of 98 percent satisfactory prophylaxis compared with only 91 percent for cefoxitin. Costs of prophylactic failure in cesarean section were calculated and then assessed for four different antibiotic regimens (based on 100 patients). Because of its high failure rate, ampicillin was the most expensive antibiotic; piperacillin was the least expensive. It was suggested that highly effective prophylaxis with an antibiotic agent such as piperacillin can result in significant cost savings when used for high-risk patients undergoing cesarean section.