Study examines clinical and economic impact of Antimicrobial Resistance at acute care facilities

New tool will enable hospitals to estimate their local burden of AMR and encourage action on infection prevention and antimicrobial stewardship

Sep 30, 2019

Mississauga, Ontario, September 30, 2019 –Researchers at BD (Becton, Dickinson and Company), Sinai Health System and University Health Network have developed an economic model for evaluating the clinical and economic impact of antimicrobial resistance (AMR).1

“Estimating the clinical and economic impact of AMR is critical to building a case for the development of antimicrobial stewardship programs in our health care facilities,” says Chelsea Smallwood, M.Sc., study co-author, associate director, Health Economics & Public Policy, BD – Canada. “With the ability to estimate the clinical and economic impact of this issue, we can illustrate the importance of infection prevention, stewardship, surveillance, and the health care professionals who manage these programs.”

The researchers developed a practical tool for evaluating the clinical and economic impact for the top five resistant organisms in the acute care setting: Klebsiella pneumonia, Escherichia coli, Enterococcus faecium, Pseudomonas aeruginosa and Staphylococcus aureus. The model used data from literature and a hospital in Ontario. Direct and indirect costs per year were included. The main limitation of the study was the lack of published data describing the incremental costs of resistant infections compared to susceptible infections.1

The study estimated that these top five infections cost $9.9 million to manage at an acute care centre. Of that, the cost of the resistant infections was $2.1 million, and the incremental cost of resistance (i.e. the additional cost to manage these patients because of resistance) was $1.1 million. The number of deaths from the top five infections in the acute care setting amounted to 149 annually. Of those, 104 were from susceptible infections and 45 due to resistant infections. Extrapolating to 100% resistance, the burden could rise to as much as $30 million and nearly 700 deaths. With increasing resistance, the growing cost of managing infections would be attributable to AMR.

By 2050, estimates suggest antimicrobial resistance (AMR) could cause 10 million deaths annually and cost up to $100 trillion globally.2 Health care facilities have been encouraged to make a business case for funding AMR stewardship programs3, however, data demonstrating AMR’s clinical and economic impact has not been well captured and analyzed.

“Tackling antimicrobial resistance needs governments and other players to be ‘all in’, and you can’t be ‘all in’ unless you recognize the economic implications of AMR,” says Dr. Andrew Morris, MD, SM(Epi), FRCPC, Medical Director, Antimicrobial Stewardship Program, Sinai Health System/University Health Network.  

Health care facilities can use the open-access tool developed in this study to estimate the clinical and economic burden of AMR within an acute care setting, starting in 2020, on and While providing a practical resource for assessing the impact of AMR, the tool also illustrates gaps in data availability. One of the main goals in the development of this tool is to initiate partnerships for generating evidence and customizing inputs for other facilities and regions.

About BD

BD is one of the largest global medical technology companies in the world and is advancing the world of health by improving medical discovery, diagnostics and the delivery of care. The company supports the heroes on the frontlines of health care by developing innovative technology, services and solutions that help advance both clinical therapy for patients and clinical process for health care providers. BD and its 65,000 employees have a passion and commitment to help enhance the safety and efficiency of clinicians' care delivery process, enable laboratory scientists to accurately detect disease and advance researchers' capabilities to develop the next generation of diagnostics and therapeutics. BD has a presence in virtually every country and partners with organizations around the world to address some of the most challenging global health issues. By working in close collaboration with customers, BD can help enhance outcomes, lower costs, increase efficiencies, improve safety and expand access to health care.

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Nadia Santoli

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  1. Smallwood, C., et al. Examining the clinical and economic impact of antimicrobial resistance at acute care facilities: a practical tool. Poster Presented at the European Congress of Clinical Microbiology & Infectious Diseases, April 2019.
  2. O'Neill J. Tackling drug-resistant infections globally: Final report and recommendations. Creative Commons Attribution 4.0 International Public Licence, 2016.
  3. Ronald Small, Whitehurst S. Developing a Business Case for an Antimicrobial Stewardship Program. Joint Commission Resources, 2012.

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