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Outpatient Cephalosporin Use
The large regional variations in utilization are suggestive of misuse
BACKGROUND
Cephalosporins and cephamycins are a class of beta-lactam bactericidal drugs with both gram-positive and gram-negative activity. They are grouped into four generations, where later classes are usually more active against aerobic gram-negative bacilli. First- and second-generation cephalosporins (cefazolin, cefaclor) are used to treat a wide variety of respiratory, skin, and ear infections. Newer generations are dispensed less frequently in the outpatient setting, but drugs like ceftriaxone and cefepime are important treatments for gram-negative hospital infections.
Even though cephalosporins have a cost advantage over most macrolides and quinolones and are often preferred to penicillins for their less frequent incidence of adverse reactions, their consumption showed the largest net decrease over the study period. Regional variation was also the largest of any class – a pattern observed in European countries, where the variations have been at least in part attributed to inappropriate use.
A REGIONAL PICTURE OF ANTIBIOTIC CONSUMPTION
