Auditing antibiotic use in a teaching hospital: focus on cefoxitin.

The prevalence and nature of antibiotic misuse in a major teaching hospital was assessed by means of a quality-of-use audit. Cefoxitin was chosen for study. The use of cefoxitin increased rapidly during the study period, accounting for 17.7% ($15300) of the pharmacy's costs for cephalosporins during the first year of its availability but 47.7% ($60707) during the second year. Cefoxitin was inappropriately used for 43% of the patients receiving it during the first 2-month audit period and for 25% of those receiving it during the second audit period, 1 year later (p less than 0.01 by chi-square analysis).