Conclusions
Determining the true economic impact of antimicrobial-drug resistance is a challenge because so many variables and perspectives are involved. Better methods are needed to assess the practical implications for those from all perspectives, whether prescriber, patient, health-care business, pharmaceutical company, or the public. Because studies completed to date have been hampered by their small size and lack of uniformity, validity of the information provided is unclear and extrapolating the studies to regional or national or international levels is questionable.
Population-based studies of the true impact of resistance would require large multicenter study groups and would be valuable to help address the different perspectives. Relevant studies will require sufficient size to describe baseline antimicrobial-drug resistance, deal with limits of random variation, and control for variables. Multicenter study groups will likely have to be assembled to provide enough observations, as well as sufficient resources. Only when this is done can there be adequate exploration of the true magnitude of the economic impact of antimicrobial-drug resistance.
The economic impact of antimicrobial-drug resistance deserves more attention from government and professional societies. Neither the summary of the Report by the American Society for Microbiology Task Force on Antibiotic Resistance nor the National Coalition on Antibiotic Resistance mention this as an important area for study or as a concern for health care (32,56). A draft public health action plan to combat antimicrobial-drug resistance published by the federal Interagency Task Force on Antimicrobial Drug Resistance notes that costs of treating resistant infections place a substantial burden on society and mentions the impact of in-hospital cost of six common kinds of resistant bacteria (57).
As the U.S. health-care system has evolved into a business in the past decade, administrators concerned with cost and benefit have become important decision makers. Thus, economic arguments are needed to convince health-system administrators that antimicrobial-drug resistance is a serious issue. The same considerations apply in other countries as well (58). Lack of attention means that funding to solve the problems is unlikely to be found. A change in perception and action is needed to give this important issue of the economic impact of antimicrobial-drug resistance the priority it deserves.
ConclusionsDetermining the true economic impact of antimicrobial-drug resistance is a challenge because so many variables and perspectives are involved. Better methods are needed to assess the practical implications for those from all perspectives, whether prescriber, patient, health-care business, pharmaceutical company, or the public. Because studies completed to date have been hampered by their small size and lack of uniformity, validity of the information provided is unclear and extrapolating the studies to regional or national or international levels is questionable.Population-based studies of the true impact of resistance would require large multicenter study groups and would be valuable to help address the different perspectives. Relevant studies will require sufficient size to describe baseline antimicrobial-drug resistance, deal with limits of random variation, and control for variables. Multicenter study groups will likely have to be assembled to provide enough observations, as well as sufficient resources. Only when this is done can there be adequate exploration of the true magnitude of the economic impact of antimicrobial-drug resistance.The economic impact of antimicrobial-drug resistance deserves more attention from government and professional societies. Neither the summary of the Report by the American Society for Microbiology Task Force on Antibiotic Resistance nor the National Coalition on Antibiotic Resistance mention this as an important area for study or as a concern for health care (32,56). A draft public health action plan to combat antimicrobial-drug resistance published by the federal Interagency Task Force on Antimicrobial Drug Resistance notes that costs of treating resistant infections place a substantial burden on society and mentions the impact of in-hospital cost of six common kinds of resistant bacteria (57).As the U.S. health-care system has evolved into a business in the past decade, administrators concerned with cost and benefit have become important decision makers. Thus, economic arguments are needed to convince health-system administrators that antimicrobial-drug resistance is a serious issue. The same considerations apply in other countries as well (58). Lack of attention means that funding to solve the problems is unlikely to be found. A change in perception and action is needed to give this important issue of the economic impact of antimicrobial-drug resistance the priority it deserves.
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