Keywords
Antimicrobial multidrug resistance
Healthcare
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Abstract
Objective: To analyze the costs associated with multidrug resistance (MDR) in hospitalized patients, highlighting the main factors impacting hospital budgets. Methods: This is a descriptive integrative literature review with a qualiquantitative approach, using electronic databases from the Regional Portal of the Virtual Health Library (BVS), PubMed, and Science Direct. Search terms included: cost, antimicrobials, and hospital-acquired infections, along with related terms such as antibacterials. Results: After applying the search strategy and inclusion/exclusion criteria, 12 articles were selected for this review. Despite methodological differences, all studies agreed on the significantly higher financial impact of MDR infections compared to susceptible pathogens. Final considerations: Bacterial resistance and hospital-acquired infections caused by multidrug-resistant organisms pose a critical challenge to healthcare systems, both clinically and economically, as MDR bloodstream infections can increase costs by tens of thousands of dollars per patient. The sustainability of healthcare services depends on integrated measures, including epidemiological surveillance, infection prevention, and professional education.
References
AGÊNCIA NACIONAL DE VIGILÂNCIA SANITÁRIA (ANVISA). Diretriz Nacional para Elaboração de Programa de Gerenciamento do Uso de antimicrobianos em Serviços de Saúde. Brasília, 2017.
AXENTE C, et al. Antimicrobial consumption, costs and resistance patterns: a two year prospective study in a Romanian intensive care unit. BMC infectious diseases, 2017; 17: 1-9.
AYED HB, et al. Prevalence and risk factors of health care–associated infections in a limited resources country: A cross-sectional study. American Journal of Infection Control, 2019; 47(8): 945-950.
DALMOLIN J, et al. Mechanisms of expression of resistance to antibiotics and public health. Arq. ciências saúde UNIPAR, 2022.
GARAU J, BASSETTI M. Role of pharmacists in antimicrobial stewardship programmes. International Journal of Clinical Pharmacy, 2018; 40(5): 948–952.
JOHNSTON KJ, et al. The incremental cost of infections associated with multidrug‐resistant organisms in the inpatient hospital setting: a national estimate. Health services research, 2019; 54(4): 782-792.
JIA H, et al. The attributable direct medical cost of healthcare associated infection caused by multidrug resistance organisms in 68 hospitals of China. BioMed research international, 2019; 2019(1): 7634528.
LARA FLO, et al. Custos da antibioticoterapia em pacientes adultos com infecção hospitalar em uma unidade de terapia intensive. Rev Pre Infec e Saúde [Internet], 2017; 3(4): 814.
NAYLOR NR, et al. The health and cost burden of antibiotic resistant and susceptible Escherichia coli bacteraemia in the English hospital setting: a national retrospective cohort study. PloS one, 2019; 14(9): e0221944.
NOGUEIRA DNG, et al. Estimativa dos custos com antimicrobianos em casos de infecção de sítio cirúrgico. Revista SOBECC, 2024; 29.
OLIVEIRA AC, et al. Custos com antimicrobianos no tratamento de pacientes com infecção. Avances en Enfermería, 2015; 33(3): 352-361.
ORGANIZAÇÃO MUNDIAL DA SAÚDE (OMS). Global action plan on antimicrobial resistance. Genebra, 2015.
O’NEILL, J. Tackling drug-resistant infections globally: final report and recommendations. Review on antimicrobial resistance, 2016.
PINHO MA, et al. Análise farmacoeconômica da terapia antimicrobiana: intervenções farmacêuticas para otimização de custos em um hospital universitário em Sergipe. Revista Foco, 2024; 17(12): e7310-e7310.
PORTELA MP, et al. Programa de gerenciamento da terapia antimicrobiana em um hospital: indicadores e estudo farmacoeconômico. Revista Eletrônica Acervo Saúde, 2024; 24(4): e15330.
ROBERTS RR, et al. Hospital and societal costs of antimicrobial-resistant infections in a Chicago teaching hospital: implications for antibiotic stewardship. Clin Infect Dis, 2009; 49(8): 1175–84.
RIU M, et al. Cost Attributable to Nosocomial Bacteremia. Analysis According to Microorganism and Antimicrobial Sensitivity in a University Hospital in Barcelona. PLoS ONE, 2016; 11(4): 0153076.
RIU M, et al. Incremental cost of nosocomial bacteremia according to the focus of infection and antibiotic sensitivity of the causative microorganism in a university hospital. Medicine, 2017; 96(17): e6645.
SANTOS SCG, et al. Epidemiologia molecular de Staphylococcus aureus no Brasil: elevada frequência de clones epidêmicos| pandêmicos, CA-MRSA e perspectivas futuras. Brazilian Journal of Development, 2021; 7(4): 35734-35751.
SILVA LA, et al. O farmacêutico clínico e os custos com antimicrobianos: um estudo em uma unidade de terapia intensiva. Saúde Coletiva (Barueri), 2021; 11(68) 7269-7278.