Antimicrobial resistance: cost and containment.

There is growing evidence that antimicrobial resistance causes serious consequences for individuals as well as leading to increased healthcare costs. The containment of resistance is therefore a policy problem which will impact on all health systems in the next few years. Unfortunately, there is, as yet, no definitive evidence suggesting that particular control measures are successful in containing either the emergence or transmission of antimicrobial resistance. Furthermore, few studies contain information about costs and even where there is such information it is generally inadequate because of the narrow perspectives from which analyses are conducted. In part, this is due to methodological problems associated with the inclusion of cost data: measuring and valuing what are often intangible costs; identifying costs associated with organizational change; and accounting for interaction between costs at levels from the individual to the international. Good quality research, including both economic evaluation and comprehensive economic modelling, is required to determine the most cost-effective combination of strategies to pursue in combating resistance, and to find ways around these methodological difficulties.