Economics of antibiotic resistance

Abstract

Antibiotics are developed to kill microorganisms; however, microorganisms develop and disseminate resistance as a reaction to antimicrobials in accordance with the laws of evolution and natural selection. Resistant and multidrug-resistant bacterial infections comprise a great problem in both the community and hospital setting. Increasing values of health expenditures, including antibiotics, is a global problem. Antibiotic resistance is not always, but usually, associated with significant morbidity, longer hospitalization, excess costs and mortality. Excess costs associated with resistant microorganisms may be due to: obligation to use more expensive antibiotics, longer hospital stay, higher mortality, delayed appropriate antibiotic therapy or a necessity to perform surgery. Optimal use of existing antimicrobial agents, using alternative treatment options (where possible), reducing the need for antimicrobials by increasing immunity, reducing the use of antimicrobials without providing an alternative form of treatment through education of health professionals and patients, antibiotic policies (including antibiotic stewardship and regulations for restricted use), implementation of infection control measures (e.g., hand washing, screening and isolation) are the strategies aimed at prevention of emergence and spread of antibiotic resistance.

Keywords::

• Acinetobacter baumannii
• antibiotic stewardship
• community-acquired infection
• cost analysis
• Enterobacteriaceae
• Escherischia coli
• extended-spectrum β-lactamases
• hospital-acquired infection
• Klebsiella pneumoniae
• methicillin-resistant Staphylococcus aureus
• Mycobacterium tuberculosis
• net present value
• nosocomial
• Proteus mirabilis
• Pseudomonas aeruginosa
• Streptococcus pneumoniae
• surveillance
• VRE

Acknowledgements

OR Sipahi thanks Sercan Ulusoy, Tansu Yamazhan, Hilal Sipahi, Elif Hakko and anonymous reviewers for their useful comments for the improvement of the manuscript. OR Sipahi is also grateful to Ebru Akyol and Sevim Sipahi (English teachers) for their English proofreading.

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.