Cargando…
Economic burden of antimicrobial resistance and inappropriate empiric treatment in Thailand
OBJECTIVE: To quantify the economic burden of bacterial antimicrobial resistance in Thailand and estimate potential savings from improving the rate of appropriate empiric treatment, where effective coverage is provided within the first days of infection. DESIGN: Cost-of-illness study. METHODS: A cos...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10369446/ https://www.ncbi.nlm.nih.gov/pubmed/37502249 http://dx.doi.org/10.1017/ash.2023.169 |
_version_ | 1785077762898264064 |
---|---|
author | Kongnakorn, Thitima Tichy, Eszter Kengkla, Kirati Kanokwanvimol, Nuttawan Suthipinijtham, Pichaya Phuripakathorn, Chanyapat Al Taie, Amer |
author_facet | Kongnakorn, Thitima Tichy, Eszter Kengkla, Kirati Kanokwanvimol, Nuttawan Suthipinijtham, Pichaya Phuripakathorn, Chanyapat Al Taie, Amer |
author_sort | Kongnakorn, Thitima |
collection | PubMed |
description | OBJECTIVE: To quantify the economic burden of bacterial antimicrobial resistance in Thailand and estimate potential savings from improving the rate of appropriate empiric treatment, where effective coverage is provided within the first days of infection. DESIGN: Cost-of-illness study. METHODS: A cost-calculator, decision-tree model was developed using published data and records from 3 Thai hospitals for patients hospitalized with antimicrobial-resistant infections between 2015 and 2019. Direct and indirect costs of antimicrobial-resistant infections were assessed over a 5-year time horizon, with outcomes derived separately for cases having received appropriate empiric treatment versus inappropriate empiric treatment. In a real-world scenario, outcomes were estimated using actual rates of inappropriate empiric treatment, and in a hypothetical scenario, outcomes were estimated using decreased rates of inappropriate empiric treatment. RESULTS: Over 5 years, in-hospital antimicrobial-resistant infections produced costs of approximately Thai baht (THB) 66.4 billion (USD 2.1 billion) in the real-world scenario and THB 65.8 billion (USD 2.1 billion) in the hypothetical scenario (0.9% cost savings relative to the real-world scenario). Most costs were attributable to income loss due to in-hospital mortality (real world: THB 53.7 billion [USD 1.7 billion]; 80.9% of costs; hypothetical: THB 53.2 billion [USD 1.7 billion]; 80.8% of costs) and hospitalization (real world: THB 10.3 billion [USD 330.8 million]; 15.5% of costs; hypothetical: THB 10.2 billion [USD 328.9 million]; 15.5% of costs). CONCLUSIONS: In-hospital antimicrobial-resistant infections produced a substantial economic toll in Thailand. This public health burden could be reduced with a strategy aimed at decreasing the rate of patients receiving inappropriate empiric treatment. |
format | Online Article Text |
id | pubmed-10369446 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-103694462023-07-27 Economic burden of antimicrobial resistance and inappropriate empiric treatment in Thailand Kongnakorn, Thitima Tichy, Eszter Kengkla, Kirati Kanokwanvimol, Nuttawan Suthipinijtham, Pichaya Phuripakathorn, Chanyapat Al Taie, Amer Antimicrob Steward Healthc Epidemiol Original Article OBJECTIVE: To quantify the economic burden of bacterial antimicrobial resistance in Thailand and estimate potential savings from improving the rate of appropriate empiric treatment, where effective coverage is provided within the first days of infection. DESIGN: Cost-of-illness study. METHODS: A cost-calculator, decision-tree model was developed using published data and records from 3 Thai hospitals for patients hospitalized with antimicrobial-resistant infections between 2015 and 2019. Direct and indirect costs of antimicrobial-resistant infections were assessed over a 5-year time horizon, with outcomes derived separately for cases having received appropriate empiric treatment versus inappropriate empiric treatment. In a real-world scenario, outcomes were estimated using actual rates of inappropriate empiric treatment, and in a hypothetical scenario, outcomes were estimated using decreased rates of inappropriate empiric treatment. RESULTS: Over 5 years, in-hospital antimicrobial-resistant infections produced costs of approximately Thai baht (THB) 66.4 billion (USD 2.1 billion) in the real-world scenario and THB 65.8 billion (USD 2.1 billion) in the hypothetical scenario (0.9% cost savings relative to the real-world scenario). Most costs were attributable to income loss due to in-hospital mortality (real world: THB 53.7 billion [USD 1.7 billion]; 80.9% of costs; hypothetical: THB 53.2 billion [USD 1.7 billion]; 80.8% of costs) and hospitalization (real world: THB 10.3 billion [USD 330.8 million]; 15.5% of costs; hypothetical: THB 10.2 billion [USD 328.9 million]; 15.5% of costs). CONCLUSIONS: In-hospital antimicrobial-resistant infections produced a substantial economic toll in Thailand. This public health burden could be reduced with a strategy aimed at decreasing the rate of patients receiving inappropriate empiric treatment. Cambridge University Press 2023-06-29 /pmc/articles/PMC10369446/ /pubmed/37502249 http://dx.doi.org/10.1017/ash.2023.169 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. |
spellingShingle | Original Article Kongnakorn, Thitima Tichy, Eszter Kengkla, Kirati Kanokwanvimol, Nuttawan Suthipinijtham, Pichaya Phuripakathorn, Chanyapat Al Taie, Amer Economic burden of antimicrobial resistance and inappropriate empiric treatment in Thailand |
title | Economic burden of antimicrobial resistance and inappropriate empiric treatment in Thailand |
title_full | Economic burden of antimicrobial resistance and inappropriate empiric treatment in Thailand |
title_fullStr | Economic burden of antimicrobial resistance and inappropriate empiric treatment in Thailand |
title_full_unstemmed | Economic burden of antimicrobial resistance and inappropriate empiric treatment in Thailand |
title_short | Economic burden of antimicrobial resistance and inappropriate empiric treatment in Thailand |
title_sort | economic burden of antimicrobial resistance and inappropriate empiric treatment in thailand |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10369446/ https://www.ncbi.nlm.nih.gov/pubmed/37502249 http://dx.doi.org/10.1017/ash.2023.169 |
work_keys_str_mv | AT kongnakornthitima economicburdenofantimicrobialresistanceandinappropriateempirictreatmentinthailand AT tichyeszter economicburdenofantimicrobialresistanceandinappropriateempirictreatmentinthailand AT kengklakirati economicburdenofantimicrobialresistanceandinappropriateempirictreatmentinthailand AT kanokwanvimolnuttawan economicburdenofantimicrobialresistanceandinappropriateempirictreatmentinthailand AT suthipinijthampichaya economicburdenofantimicrobialresistanceandinappropriateempirictreatmentinthailand AT phuripakathornchanyapat economicburdenofantimicrobialresistanceandinappropriateempirictreatmentinthailand AT altaieamer economicburdenofantimicrobialresistanceandinappropriateempirictreatmentinthailand |