Objectives
This research aims to quantify the burden of antimicrobial resistance (AMR) from the perspective of hospital stakeholders and the value of continued investment in developing new treatments.
Methods
A dataset representative of the US population demographics and health characteristics was constructed by merging the American Community Survey, Behavioral Risk Factor Surveillance System and data on nursing home residents. Prediction equations linking patient demographics and health characteristics to likelihood of hospitalization within hospital service lines were generated using the Medical Expenditure Panel Survey and applied to the population file. Data from the National Healthcare Safety Network were used to calculate state-specific rates of AMR in hospitalized patients experiencing an infection. Peer-reviewed published research provided estimates for AMR-attributable outcomes, including mortality, inpatient days, and direct & indirect costs. Results were calculated under a base case scenario reflecting current rates of infection continuing into the future, and alternative scenarios reflecting changes in future rates of infection and resistance.
Results
Base case results suggested approximately 4,100 AMR-attributable deaths would occur in the base modeling year, resulting in over $700 million in direct costs, increasing to 5,300 deaths and $907 million in direct costs by 2035. Under a scenario in which rates of resistance increase to 100%, reflecting a hypothetical scenario where alternative antimicrobial treatments are no longer effective, projected 2035 AMR-attributable deaths increase to 30,700 (480% increase from base case) and direct costs of $8.4 billion (826% increase from base case). Infections are projected be highest in general surgery and thoracic surgery service lines, where high infection risk could potentially make surgeries too risky to perform.
Conclusions
Though its current burden is substantial, AMR’s potential future burden is significantly more concerning. Investing in AMR prevention strategies will be necessary to reverse course with respect to increasing resistance.
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