High cost burden and health consequences of antibiotic resistance: the price to pay

  • Sujith J Chandy Karolinska Institutet, Stockholm, Sweden
  • Girish S Naik Christian Medical College, Vellore, Tamil Nadu, India
  • Veeraraghavan Balaji Christian Medical College, Vellore, Tamil Nadu, India
  • Visalakshi Jeyaseelan Christian Medical College, Vellore, Tamil Nadu, India
  • Kurien Thomas Christian Medical College, Vellore, Tamil Nadu, India
  • Cecilia Stalsby Lundborg Christian Medical College, Vellore, Tamil Nadu, India
Keywords: antibiotics, antimicrobial resistance, economic burden

Abstract

Introduction: Rising antibiotic resistance may negatively affect the health and cost of care for patients. This study aimed to determine the impact of antibiotic resistance on costs and health consequences for patients.

Methodology:  A one-year observational study was conducted at Christian Medical College, Vellore, a tertiary care hospital, on patients admitted into medical wards with a preliminary diagnosis of suspected sepsis. Patients with confirmed bacteremia were analysed in two groups – resistant and susceptible – based on susceptibility of causative bacteria to the empiric antibiotics administered. Clinical data and details about costs incurred were collected from hospital records. Costs and health consequences were compared using Mann-Whitney U test and Fisher’s exact test. For median difference in costs, 95% bootstrap confidence interval was determined.

Results: Overall, 220 patients were included. The median difference between resistant and susceptible groups in overall costs, antibiotic costs, and pharmacy costs was rupees (INR)/USD 41,993/700 (p = 0.001), 8,315/139 (p < 0.001) and 21,492/358 (p < 0.001), respectively. Health consequences such as intensive care admissions, complications, mortality, and length of stay were significantly higher in the resistant group as compared to susceptible group: 44% vs. 21% (p < 0.001), 56% vs. 37% (p = 0.006), 12% vs. 2% (p = 0.011), and 14 vs. 11 days (p = 0·027), respectively.

Conclusions: Antibiotic resistance has a significant impact on cost and health consequences. These findings provide a key message for policymakers and other stakeholders to initiate feasible strategies to tackle resistance and reduce the burden.

Author Biographies

Sujith J Chandy, Karolinska Institutet, Stockholm, Sweden

1. Global Health (IHCAR), Dept of Public Health Sciences

2. Dept of Pharmacology & Clinical Pharmacology

Girish S Naik, Christian Medical College, Vellore, Tamil Nadu, India
Dept of Pharmacology & Clinical Pharmacology
Veeraraghavan Balaji, Christian Medical College, Vellore, Tamil Nadu, India
Dept of Clinical Microbiology
Visalakshi Jeyaseelan, Christian Medical College, Vellore, Tamil Nadu, India
Dept of Biostatistics
Kurien Thomas, Christian Medical College, Vellore, Tamil Nadu, India
Dept of Medicine
Cecilia Stalsby Lundborg, Christian Medical College, Vellore, Tamil Nadu, India
Global Health (IHCAR), Dept of Public Health Sciences
Published
2014-09-12
How to Cite
1.
Chandy S, Naik G, Balaji V, Jeyaseelan V, Thomas K, Lundborg C (2014) High cost burden and health consequences of antibiotic resistance: the price to pay. J Infect Dev Ctries 8:1096-1102. doi: https://doi.org/10.3855/jidc.4745
Section
Original Articles