Impact of antimicrobial multidrug resistance on inpatient care cost: an evaluation of the evidence

Expert Rev Anti Infect Ther. 2013 Mar;11(3):321-31. doi: 10.1586/eri.13.4.


This article evaluates the in-hospital costs attributable to antimicrobial multidrug resistance, defined as the difference in averaged costs of the patients infected with a multidrug-resistant (MDR) versus a non-MDR organism. PubMed and Scopus databases were searched to identify relevant studies. Twenty four studies were included: four on carbapenem-resistant or MDR Gram negative nonfermenters, eight on extended-spectrum b-lactamase-producing Enterobacteriaceae and 12 on methicillin-resistant Staphylococcus aureus. In two studies on carbapenem-resistant nonfermenters, the attributable mean hospital charges were US$58,457 and 85,299, respectively. The attributable mean total costs were US$4484 in a study referring to MDR Acinetobacter baumannii, while that varied from US$1584 to 30,093 among studies on extended-spectrum b-lactamase-producing Enterobacteriaceae. With respect to methicillin-resistant S. aureus, the attributable mean total costs varied from US$1014 to 40,090. The in-hospital costs attributable to multidrug resistance are alarmingly high, justifying the application of strict infection control measures in medical institutions with increased rate of MDR infections.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / economics*
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / economics
  • Bacterial Infections / therapy
  • Carbapenems / pharmacology
  • Cross Infection / drug therapy
  • Cross Infection / economics*
  • Drug Resistance, Multiple, Bacterial*
  • Enterobacteriaceae / drug effects
  • Gram-Negative Bacteria / drug effects*
  • Hospital Costs*
  • Humans
  • Methicillin-Resistant Staphylococcus aureus / drug effects*
  • beta-Lactams / pharmacology


  • Anti-Bacterial Agents
  • Carbapenems
  • beta-Lactams