Journal article
Quantifying the economic cost of antibiotic resistance and the impact of related interventions: Rapid methodological review, conceptual framework and recommendations for future studies
- Abstract:
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Background:
Antibiotic resistance (ABR) poses a major threat to health and economic wellbeing worldwide. Reducing ABR will require government interventions to incentivize antibiotic development, prudent antibiotic use, infection control, and deployment of partial substitutes such as rapid diagnostics and vaccines. The scale of such interventions needs to be calibrated to accurate and comprehensive estimates of the economic cost of ABR.
Methods and Results:
A conceptual framework for estimating costs attributable to ABR was developed based on previous literature highlighting methodological shortcomings in the field and additional deductive epidemiological and economic reasoning. The framework was supplemented by a rapid methodological review that identified 110 articles quantifying ABR costs. Most were based in high-income countries only (91/110), set in hospitals (95/110), used a healthcare provider or payer perspective (97/110) and used matched cohort approaches to compare costs of patients with antibiotic-resistant infections and antibiotic-susceptible infections (or no infection) (87/110). Better use of methods to correct biases and confounding when making this comparison is needed. Findings also need to be extended beyond their limited perspective in (i) time (projecting present costs into the future), (ii) perspective (from the healthcare sector to entire societies and economies), (iii) scope (from individuals to communities and ecosystems) and (iv) space (from single sites to countries and the world). Analyses of the impact of interventions need to be extended to examine the impact of the intervention on ABR, rather than considering ABR as an exogeneous factor.
Conclusions:
Quantifying the economic cost of resistance will require greater rigour and innovation in the use of existing methods to design studies that accurately collect relevant outcomes and further research into new techniques for capturing broader economic outcomes.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, pdf, 2.0MB, Terms of use)
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- Publisher copy:
- 10.1186/s12916-020-1507-2
Authors
- Publisher:
- BioMed Central
- Journal:
- BMC Medicine More from this journal
- Volume:
- 18
- Article number:
- 38
- Publication date:
- 2020-03-06
- Acceptance date:
- 2020-01-31
- DOI:
- EISSN:
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1741-7015
- ISSN:
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1741-7015
- Language:
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English
- Keywords:
- Pubs id:
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1084212
- Local pid:
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pubs:1084212
- Deposit date:
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2020-02-01
- ARK identifier:
Terms of use
- Copyright holder:
- Jit et al.
- Copyright date:
- 2020
- Rights statement:
- © The Author(s) 2020. Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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