The impact of antimicrobial resistance on health and economic outcomes. Clinical Infectious Diseases

Despite an increasing prevalence of antimicrobial-resistant pathogens, the health and economic impact of colonization and infection with these organisms has not been fully elucidated. We explore how antimicrobial resistance can affect patient outcomes by enhancing virulence, causing a delay in the administration of appropriate therapy, and limiting available therapy. Next, we examine the different perspectives held by hospitals, third-party payers, patients, and society on the impact of resistance. Finally, we review methodological issues in designing and assessing studies that address the clinical outcomes for patients infected or colonized with resistant pathogens, including adjustment for important confounding variables, control group selection, and the quantification of economic outcomes. Although the problem of antimicrobial resistance has attracted the attention of both the medical community and the general public, the magnitude of the impact of resistance on health and economic outcomes remains largely unknown. Rates of antimicrobial resistance among hospital and community path-ogens have increased considerably during the past decade [1]. Relatively few resources have been allocated to understand, prevent, and control the spread of resistance on global, national