Abstract
BackgroundEstimates of the burden of antimicrobial resistance (AMR) are needed to ascertain AMR impact, to evaluate interventions, and to allocate resources efficiently. Recent studies have estimated health, cost, and economic burden relating to AMR, with outcomes of interest ranging from drug-bug resistance impact on mortality in a hospital setting to total economic impact of AMR on the global economy. However, recent collation of this information has been largely informal, with no formal quality assessment of the current evidence base (e.g. with predefined checklists). This review therefore aims to establish what perspectives and resulting methodologies have been used in establishing the burden of AMR, whilst also ascertaining the quality of these studies.MethodsThe literature review will identify relevant literature using a systematic review methodology. MEDLINE, EMBASE, Scopus and EconLit will be searched utilising a predefined search string. Grey literature will be identified by searching within a predefined list of organisational websites. Independent screening of retrievals will be performed in a two-stage process (abstracts and full texts), utilising a pre-defined inclusion and exclusion criteria. Data will be extracted into a data extraction table and descriptive examination will be performed. Study quality will be assessed using the Newcastle-Ottawa scales and the Philips checklists where appropriate. A narrative synthesis of the results will be presented.DiscussionThis review will provide an overview of previous health, cost and economic definitions of burden and the resultant impact of these different definitions on the burden of AMR estimated. The review will also explore the methods that have been used to calculate this burden and discuss resulting study quality. This review can therefore act as a guide to methods for future research in this area.Systematic review registrationPROSPERO CRD42016037510Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0364-8) contains supplementary material, which is available to authorized users.
Highlights
Estimates of the burden of antimicrobial resistance (AMR) are needed to ascertain AMR impact, to evaluate interventions, and to allocate resources efficiently
AMR-associated burden can be defined as AMR impact on health, impact on healthcare and patient costs or impact on the economy depending on study perspective
Recent estimates for the burden suggest that AMR that it is a significant economic burden to the global economy [1], whilst previous reviews have suggested that perhaps study outcome and methodology impacts whether AMR is found to have a significant burden or not [8]
Summary
Estimates of the burden of antimicrobial resistance (AMR) are needed to ascertain AMR impact, to evaluate interventions, and to allocate resources efficiently. The AMR review, chaired by Jim O’Neill, has recently published estimates of potential future AMR burden, for example stating global gross domestic product (GDP) loss over the 40 years could be as great as $3 trillion [1]. These estimates have since been cited by policy makers and the media [3, 4], showing the demand for estimates quantifying the current and potential future problem AMR poses.
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