Comparison of the Effects of Prophylactic Antibiotic Therapy and Cost-effectiveness between Cefazolin (CEZ) and Sulbactam/Ampicillin (SBT/ABPC) in Gastric Cancer Surgery Employing Clinical Pathway

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  • ISE Yuya
    Department of Pharmceutical Service, Nippon Medical School Hospital
  • HAGIWARA Ken
    Department of Pharmceutical Service, Nippon Medical School Hospital Faculty of Pharmaceutical Sciences, Josai University
  • SAITOH Setsuo
    Faculty of Pharmaceutical Sciences, Josai University
  • HONJO Kazuyoshi
    Department of Pharmceutical Service, Nippon Medical School Hospital
  • SOH Shizuka
    Department of Pharmceutical Service, Nippon Medical School Hospital
  • KATO Ayumi
    Department of Pharmceutical Service, Nippon Medical School Hospital
  • KATAYAMA Shirou
    Department of Pharmceutical Service, Nippon Medical School Hospital
  • NISHIZAWA Kenji
    Department of Pharmceutical Service, Nippon Medical School Hospital
  • HIRANO Masaaki
    Department of Pharmceutical Service, Nippon Medical School Hospital
  • YOSHIYUKI Toshiro
    Department of Surgery (I), Nippon Medical School Hospital
  • KIYAMA Teruo
    Department of Surgery (I), Nippon Medical School Hospital
  • MITSUHASHI Kyoko
    Department of Nursing, Nippon Medical School Hospital
  • KAMEI Miwako
    Social and Administrative Pharmacy Sciences, College of Pharmacy, Nihon University
  • SHIRAGAMI Makoto
    Social and Administrative Pharmacy Sciences, College of Pharmacy, Nihon University

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Other Title
  • クリニカルパス適用胃切除患者におけるCefazolin（CEZ）とSulbactam/Ampicillin (SBT/ABPC）の術後感染発症阻止効果並びに費用対効果の比較
  • クリニカル パス テキヨウ イ セツジョ カンジャ ニ オケル Cefazolin CEZ ト Sulbactam Ampicillin SBT ABPC ノ ジュツゴ カンセン ハッショウ ソシ コウカ ナラビニ ヒヨウ タイ コウカ ノ ヒカク

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Abstract

  The present study was designed to investigate the effects of prophylactic antibiotic therapy and the cost-effectiveness of Cefazolin (CEZ) and Sulbactam/Ampicillin (SBT/ABPC) in gastric cancer surgery employing clinical pathway. 157 patients (62 in the CEZ group and 95 in the SBT/ABPC group), who underwent surgery for gastric cancer at the First Department of Surgery of our hospital, were investigated. There was no significant difference between the groups with regard to sex, age, incidence of complication, stage of cancer, surgical method, operative time and blood loss, length of hospitalization, the appearance of systemic inflammatory response syndrome (SIRS), changes body tempreture, white blood cell count (WBC), C-reactive protein (CRP), or clinical outcome of postoperative care by a nurse during post-operation for 7 days. The prophylactic effect of infection was also no different between the CEZ (69.4%) and SBT/ABPC (69.5%) groups. In contrast, decision analysis strongly indicated that the anticipate cost of antibiotics was higher in the latter group (¥20402) than in the CEZ group (¥15556), suggesting that the prophylactic effect of CEZ may be more cost-effective. Thus, evaluations of pharmacotherapy from the aspect of cost may be one of the important responsibility of hospital pharmacists in the future.<br>

Journal

  • YAKUGAKU ZASSHI

    YAKUGAKU ZASSHI 124 (11), 815-824, 2004-11-01

    The Pharmaceutical Society of Japan

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