Evaluation of restricted antibiotic utilization and cost-minimization analysis in a tertiary care hospital in India


  • Dhakchinamoorthi Krishna Kumar Department of Pharmacy Practice/ Clinical Pharmacy, Karpagam College of Pharmacy, Karpagam Medical College & Hospital, Coimbatore, India http://orcid.org/0000-0001-8591-1636
  • Mani Swapna Clinical Pharmacologist, Manipal Hospitals, New Delhi, India
  • Srinivasan Kanmani Regional Project Manager, Servier Pharmaceuticals (India), Chennai, India
  • Varghese Varsha Clinical Pharmacist, KIMS Health, Trivandrum, Kerala, India
  • Nair V. Vidya Pharmacist, DMC Hospital, Thadiyoor, Kerala, India




Antimicrobial, Cost Minimization, Pharmacoeconomic, Restricted antibiotics


Background: Antibiotic resistance is a major menace to public health and treatment of several infectious diseases, also associated with an economic burden to society.  Pharmacoeconomic analysis of antibiotic usage and cost-minimization analysis provides better and low-cost drug selection for the patients.

Methods: The study was conducted as a cross-sectional, observational analysis of restricted antibiotics in the prescriptions (n= 191). Cost minimization analysis was conducted for the restricted antibiotics alone. The drug costs of prescribed brands were compared with the least cost brands, and the percentage cost difference was calculated and compared by student paired ‘t’ test. P<0.05 considered statistical significance.  

Results: The average age of the patients was found to be 58.1±18.3 (Mean±SD) years, and most of the restricted antibiotics were prescribed for the treatment of hospital-acquired infections 71.7%. Meropenem was prescribed highly 29.8% followed by imipenem (28.8%) and colistin (12%). The major reason for starting restricted antibiotics was found to be infectious diseases (27.7%). The cost-minimization analysis showed that the total unit cost for caspofungin (₹1,85,000 or $2523.40) was found to be higher followed by meropenem (₹1,29,800) in the prescriptions. The mean cost of actually prescribed restricted antibiotics was found to be ₹68,338±61,332 (Mean±SD). The lowest mean cost of restricted antibiotics was found to be ₹32,223±31,082 (p<0.05).

Conclusions: Pharmacoeconomic cost-minimization analysis was a useful tool for clinical pharmacist in the selection of appropriate antibiotics and minimizing the burden of the cost of the drugs, it provides a better outcome in patients while using restricted antibiotics with infectious disease.


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