Excess annual economic burdens from nosocomial infections caused by multi-drug resistant bacteria in Thailand

ABSTRACT

Background – Antimicrobial resistance (AMR) is a major health threat worldwide as it brings about poorer outcomes and places economic burdens to society. This study aims to estimate the economic burdens from nosocomial infections (NI) caused by multi-drug resistant (MDR) bacteria in Thailand.

Research design and methods – A retrospective cohort study was conducted at a tertiary hospital over 2011–2012. A multivariate log-linear regression model was used to estimate the excess treatment costs of AMR to those non-AMR patients.

Results – Switching from a non-AMR case to an AMR infection case, resulted in 42% increase in expected average treatment costs per patient. The annual treatment from hospital perspective and antibiotic costs associated with the management of AMR infections were estimated to be US$ 2.3 billion and US$ 262 million, respectively. The estimated annual benefit from eradicating AMR NI were US$ 4.2 billion from a societal perspective with the annual gains in quality-adjusted life years (QALYs) of 0.6 million due to the absence of 111,295 AMR cases each year.

Conclusions – Large amount of money was spent on treatment and antibiotic costs to manage AMR infections. Benefit of eliminating these infections was estimated and it would be highly cost-effective.

KEYWORDS:

• Antimicrobial resistance
• cost
• multi-drug resistant
• nosocomial infection
• Thailand

Acknowledgments

We gratefully thank the Ramathibodi Hospital for supporting and facilitating the study.

Declaration of interest

The authors have 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.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conception and design: Tuangrat Phodha, Arthorn Riewpaiboon, and Kumthorn Malathum. Data collection: Tuangrat Phodha. Data analysis and interpretation: All Drafting the paper: Arthorn Riewpaiboon. Manuscript revision: All. Final approval: Arthorn Riewpaiboon (corresponding author). All authors agree to be accountable for all aspects of the work.

Additional information

Funding

Funding was provided by the Thailand Research Fund through the Royal Golden Jubilee Ph.D. Program [Grant No. PHD/0276/2551].