A national evaluation of antibiotic expenditures by healthcare setting in the United States, 2009

J Antimicrob Chemother. 2013 Mar;68(3):715-8. doi: 10.1093/jac/dks445. Epub 2012 Nov 11.


Objectives: Promoting appropriate antibiotic use has the potential to decrease healthcare costs by reducing unnecessary prescriptions and the incidence of resistant infections. However, little is known about where antibiotic costs are incurred in the US healthcare system. We evaluated antibiotic expenditures by healthcare setting and antibiotic class in the USA.

Methods: Systemic antibiotic expenditures in 2009 were extracted from the IMS Health(©) National Sales Perspectives database. These data represent a statistically valid projection of all medication purchases in the USA from 1 January 2009 to 31 December 2009.

Results: Antibiotic expenditures totalled $10.7 billion. The majority (61.5%) of expenditures were associated with the outpatient setting, especially from community pharmacies. Inpatient and long-term care settings accounted for 33.6% and 4.9% of expenditures, respectively. The class of antibiotics that accounted for the most antibiotic expenditure overall was the quinolones, followed by the penicillins.

Conclusions: Over $10.7 billion was spent in 2009 on antibiotic therapy in the USA. Differences were observed in antibiotic expenditures by healthcare setting, with the majority in the outpatient setting, 87% of which was in community pharmacies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / economics*
  • Anti-Bacterial Agents / therapeutic use*
  • Health Care Costs / statistics & numerical data*
  • Humans
  • United States


  • Anti-Bacterial Agents