The economic burden of antibiotic resistance: A systematic review and meta-analysis.

<h4>Introduction</h4>Antibiotic resistance (ABR) has substantial global public health concerns. This systematic review aimed to synthesise recent evidence estimating the economic burden of ABR, characterised by study perspectives, healthcare settings, study design, and income of the coun...

Full description

Saved in:
Bibliographic Details
Main Authors: Ak Narayan Poudel, Shihua Zhu, Nicola Cooper, Paul Little, Carolyn Tarrant, Matthew Hickman, Guiqing Yao
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0285170
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849469814682157056
author Ak Narayan Poudel
Shihua Zhu
Nicola Cooper
Paul Little
Carolyn Tarrant
Matthew Hickman
Guiqing Yao
author_facet Ak Narayan Poudel
Shihua Zhu
Nicola Cooper
Paul Little
Carolyn Tarrant
Matthew Hickman
Guiqing Yao
author_sort Ak Narayan Poudel
collection DOAJ
description <h4>Introduction</h4>Antibiotic resistance (ABR) has substantial global public health concerns. This systematic review aimed to synthesise recent evidence estimating the economic burden of ABR, characterised by study perspectives, healthcare settings, study design, and income of the countries.<h4>Methods</h4>This systematic review included peer-reviewed articles from PubMed, Medline, and Scopus databases, and grey literature on the topic of the economic burden of ABR, published between January 2016 and December 2021. The study was reported in line with 'Preferred Reporting Items for Systematic Review and Meta-Analysis' (PRISMA). Two reviewers independently screened papers for inclusion first by title, then abstract, and then the full text. Study quality was assessed using appropriate quality assessment tools. Narrative synthesis and meta-analyses of the included studies were conducted.<h4>Results</h4>A total of 29 studies were included in this review. Out of these studies, 69% (20/29) were conducted in high-income economies and the remainder were conducted in upper-and-middle income economies. Most of the studies were conducted from a healthcare or hospital perspective (89.6%, 26/29) and 44.8% (13/29) studies were conducted in tertiary care settings. The available evidence indicates that the attributable cost of resistant infection ranges from -US$2,371.4 to +US$29,289.1 (adjusted for 2020 price) per patient episode; the mean excess length of stay (LoS) is 7.4 days (95% CI: 3.4-11.4), the odds ratios of mortality for resistant infection is 1.844 (95% CI: 1.187-2.865) and readmission is 1.492 (95% CI: 1.231-1.807).<h4>Conclusion</h4>Recent publications show that the burden of ABR is substantial. There is still a lack of studies on the economic burden of ABR from low-income economies, and lower-middle-income economies, from a societal perspective, and in relation to primary care. The findings of this review may be of value to researchers, policymakers, clinicians, and those who are working in the field of ABR and health promotion.<h4>Systematic review registration</h4>CRD42020193886.
format Article
id doaj-art-bbaf9dd36298459a929ea8784b7137b9
institution Kabale University
issn 1932-6203
language English
publishDate 2023-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-bbaf9dd36298459a929ea8784b7137b92025-08-20T03:25:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01185e028517010.1371/journal.pone.0285170The economic burden of antibiotic resistance: A systematic review and meta-analysis.Ak Narayan PoudelShihua ZhuNicola CooperPaul LittleCarolyn TarrantMatthew HickmanGuiqing Yao<h4>Introduction</h4>Antibiotic resistance (ABR) has substantial global public health concerns. This systematic review aimed to synthesise recent evidence estimating the economic burden of ABR, characterised by study perspectives, healthcare settings, study design, and income of the countries.<h4>Methods</h4>This systematic review included peer-reviewed articles from PubMed, Medline, and Scopus databases, and grey literature on the topic of the economic burden of ABR, published between January 2016 and December 2021. The study was reported in line with 'Preferred Reporting Items for Systematic Review and Meta-Analysis' (PRISMA). Two reviewers independently screened papers for inclusion first by title, then abstract, and then the full text. Study quality was assessed using appropriate quality assessment tools. Narrative synthesis and meta-analyses of the included studies were conducted.<h4>Results</h4>A total of 29 studies were included in this review. Out of these studies, 69% (20/29) were conducted in high-income economies and the remainder were conducted in upper-and-middle income economies. Most of the studies were conducted from a healthcare or hospital perspective (89.6%, 26/29) and 44.8% (13/29) studies were conducted in tertiary care settings. The available evidence indicates that the attributable cost of resistant infection ranges from -US$2,371.4 to +US$29,289.1 (adjusted for 2020 price) per patient episode; the mean excess length of stay (LoS) is 7.4 days (95% CI: 3.4-11.4), the odds ratios of mortality for resistant infection is 1.844 (95% CI: 1.187-2.865) and readmission is 1.492 (95% CI: 1.231-1.807).<h4>Conclusion</h4>Recent publications show that the burden of ABR is substantial. There is still a lack of studies on the economic burden of ABR from low-income economies, and lower-middle-income economies, from a societal perspective, and in relation to primary care. The findings of this review may be of value to researchers, policymakers, clinicians, and those who are working in the field of ABR and health promotion.<h4>Systematic review registration</h4>CRD42020193886.https://doi.org/10.1371/journal.pone.0285170
spellingShingle Ak Narayan Poudel
Shihua Zhu
Nicola Cooper
Paul Little
Carolyn Tarrant
Matthew Hickman
Guiqing Yao
The economic burden of antibiotic resistance: A systematic review and meta-analysis.
PLoS ONE
title The economic burden of antibiotic resistance: A systematic review and meta-analysis.
title_full The economic burden of antibiotic resistance: A systematic review and meta-analysis.
title_fullStr The economic burden of antibiotic resistance: A systematic review and meta-analysis.
title_full_unstemmed The economic burden of antibiotic resistance: A systematic review and meta-analysis.
title_short The economic burden of antibiotic resistance: A systematic review and meta-analysis.
title_sort economic burden of antibiotic resistance a systematic review and meta analysis
url https://doi.org/10.1371/journal.pone.0285170
work_keys_str_mv AT aknarayanpoudel theeconomicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT shihuazhu theeconomicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT nicolacooper theeconomicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT paullittle theeconomicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT carolyntarrant theeconomicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT matthewhickman theeconomicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT guiqingyao theeconomicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT aknarayanpoudel economicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT shihuazhu economicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT nicolacooper economicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT paullittle economicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT carolyntarrant economicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT matthewhickman economicburdenofantibioticresistanceasystematicreviewandmetaanalysis
AT guiqingyao economicburdenofantibioticresistanceasystematicreviewandmetaanalysis