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Table 1 Estimates of national, multinational and global costs of antibiotic resistance. Costs were inflated using local GDP deflators and converted to 2018 international dollars (I$) using purchasing power parities, both from data published by the World Bank and OECD

From: Quantifying the economic cost of antibiotic resistance and the impact of related interventions: rapid methodological review, conceptual framework and recommendations for future studies

StudyGeographyPathogensCosts in original currencyCosts in 2018 I$Costs considered
Studies in the grey literature
 ECDC and EMEA [6]EU, Iceland, NorwayS. aureus, Enterococcus spp., S. pneumoniae, E. coli, Klebsiella spp., P. aeruginosa1.5 bn/year EUR (2007)2.1 bn/yearIncreased treatment costs, reduced productivity and labour supply due to morbidity and premature mortality
 KPMG [19]EU, Iceland, Norway
Global
E. coli, K. pneumoniae, S. aureus, HIV, TB, malaria1.6 bn/year EUR (2012)
1.66–6.08% of global GDP in 2050
2.3 bn/yearIncreased treatment costs, reduced productivity and labour supply due to morbidity and premature mortality
 RAND Europe [20]GlobalE. coli, K. pneumoniae, S. aureus, HIV, TB, malaria0.5–6.0 tn USD (2011) per year in 40 years (0.14–1.9% of global GDP)0.6–6.8 tn per year in 40 yearsReduced labour supply and productivity due to increased morbidity, mortality and caregiving
Reduced inter-sectoral transactions and trade
 World Bank [7]GlobalAny1.0–3.4 tn USD (2017) per year in 2030 (1.1–3.8% of global GDP)1.0–3.5 tn I$ per year in 2030Reduced labour supply due to premature mortality
Studies in the rapid review of published literature
 Chen et al. [45]EthiopiaS. pneumoniae15.8 m/year USD (2017)16.2 m/yearIncreased treatment costs and productivity losses due to morbidity and premature mortality
 Chesson et al. [46]USAN. gonorrhoeae378 m/year USD (2016)395 m/yearIncreased treatment costs
 de Kraker et al. [32]31 European countriesBloodstream infections caused by MRSA and G3CREC62 m/year EUR (2007)87 m/yearIncreased length of hospital stay
 Elbasha [47]USAAny0.4–19 bn/year USD (1996)0.6–29 bn/year“Deadweight loss”: reduced antibiotic effectiveness leading to poorer treatment outcomes due to overprescribing antibiotics
 Johnston et al. [48]United StatesMulti-drug resistant organism2.39–3.38 bn/year USD (2017)2.45–3.46 bn/yearIncreased treatment costs
 Lee et al. [49]USACommunity-associated MRSAHealthcare: 478 m/year USD (2011)
Society: 2.2 bn/year USD (2011)
Healthcare: 539 m/year
Society: 2.5 bn/year
Increased treatment costs and productivity loss due to morbidity and premature mortality
 Michaelidis et al. [50]USAAny4.4 bn/year USD (2013)4.8 bn/yearCost of antibiotic use and stewardship
 Naylor et al. [29]EnglandE. coliThird-generation cephalosporin: 366,600/year GBP (2012) Piperacillin/tazobactam: 275,4000/year GBP (2012)Third-generation cephalosporin: 578,000/year
Piperacillin/tazobactam: 434,000
Increased treatment costs
 Phelps [37]USAAny0.15–3 bn/year USD (1984)0.3–6.3 bn/yearTreatment costs, mortality
 Phodha et al. [51]ThailandNosocomial infections due to five bacterial speciesHealthcare: 2.3 bn/year USD (2012)
Society: 4.2 bn/year USD (2012)
Healthcare: 2.5 bn/year
Society: 4.6 bn/year
Increased treatment costs
Increased societal costs (components not reported)
 Shrestha et al. [52]USA and ThailandAnyUSA: 2.9 bn/year USD (2016)
Thailand: 0.5 bn/year USD (2016)
USA: 3.0 bn/year
Thailand:0.5 bn/year
Increased treatment costs and productivity loss due to morbidity and premature mortality
 Smith et al. [39]UKMRSA0.4–1.6% of national GDP, equivalent to 3–11 bn GBP (1995)6.5–24.0 bnReduced labour supply and productivity, leading to less capital investment and lowered productivity
 Thorpe et al. [53]USAAny2.2 bn/year USD (2016)2.3 bn/year I$Increased treatment costs due to morbidity
 Tillekeratne et al. [54]Sri LankaAny229 m/year USD (2017)235 m/yearNot specified – costs extrapolated from US and Thai studies
 Touat et al. [55]FranceGram-negative bacteria287 m/year EUR (2015)397 m/yearIncreased treatment costs
 US Congress, Office of Technology Assessment [56]USANosocomial infections due to six bacterial species1.3 bn/year USD (1992)2.1 bn/yearHospital treatment costs
 Zhen et al. [57]ChinaIntra-abdominal bacterial infectionsHealthcare: 37 bn/year CNY (2015)
Society: 111 bn/year CNY (2015)
Healthcare: 12 bn/year
Society: 35 bn/year
Increased treatment costs, 3x multiplier for societal costs
  1. bn billion, CNY Chinese Yen, ECDC European Centre for Disease Prevention and Control, EMEA European Medicines Agency, G3CREC third-generation cephalosporin-resistant E. coli, MRSA methicillin-resistant Staphylococcus aureus, TB tuberculosis, tn trillion, USD US Dollar