A look at hospital inpatient formularies and drug use for pneumonia reveals a dramatic shift in therapy over the last five years. This information is based on a panel of representative hospitals reporting their formulary and drug usage data by diagnosis on an ongoing basis to MediMedia USA. This ongoing study (the Hospital Diagnosis and Therapy Audit) monitors all inpatients in the panel hospitals and the drug therapy they received.

Based on an analysis of formulary and drug usage, cephalosporins remain the most widely prescribed therapy for inpatients with pneumonia; however, the introduction of quinolones to hospital formularies has eroded the cephalosporin market share considerably in the past few years. Seventy-six percent of pneumonia patients received some type of cephalosporin in 1998 compared to only 59 percent in 2002. Simultaneously, systemic quinolone therapy rose from 28 percent in 1998 to over 56 percent in 2002. In the quinolone market, Levaquin has remained on top, replacing Cipro, and increasing from 33 percent in 1998 to 61 percent in 2002. These products have made a big impact on hospital formularies, partly because of their dosing schedules. Most cephalosporins, except for Rocephin, need to be administered every eight hours, while the newer quinolones are administered once daily. The slightly higher price of the drugs is offset by the decrease in time spent by the nursing staff.

The Hospital Diagnosis and Therapy Audit reports information quarterly from over a million inpatients, collected from short-term, nonspecialty, nonfederal hospitals. This service is used as an information source for pharmaceutical manufacturers and has been in continuous operation for 14 years.