Cephalosporin-use restrictions in teaching hospitals.

A survey of pharmacy directors in teaching hospitals was conducted in March 1983 to ascertain policies for management of cephalosporin use. Surveys were sent to 298 institutions in each of the United States except Alaska. Respondents were asked various questions regarding hospital policies on cephalosporin use. Responses were received from 179 hospitals that had formularies; 99 of these had formal restriction policies, more frequently for second- and third-generation agents than for first-generation agents, and 13 planned to institute restriction policies. In 68% of hospitals with restriction policies, restricted drugs were released only after consultation with the infectious disease service. Chart review was the most frequently reported method of monitoring use of restricted cephalosporins. Approximately 40% of respondents had therapeutic equivalence policies, and more than 40% had recently deleted one or more cephalosporins from the formulary. The percentage of hospitals with formal restriction policies (55%) was greater than in a 1979 survey (32%). Many teaching hospitals have initiated policies to curb rising drug costs associated with the use of cephalosporin antibiotics.