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. 2022 Apr 1;11(1):53.
doi: 10.1186/s13756-022-01096-w.

Exploring the economic impact of inappropriate antibiotic use: the case of upper respiratory tract infections in Ghana

Jip Janssen  1 , Samuel Afari-Asiedu  2 , Annelie Monnier  3 , Martha Ali Abdulai  2 , Theresa Tawiah  2 , Heiman Wertheim  4 , Rob Baltussen  1 , Kwaku Poku Asante  2
Affiliations

Exploring the economic impact of inappropriate antibiotic use: the case of upper respiratory tract infections in Ghana

Jip Janssen et al. Antimicrob Resist Infect Control. .

Abstract

Background: Antibiotic consumption is increasing worldwide, particularly in low and middle-income countries (LMICs). Access to lifesaving antibiotics in LMICs is crucial while minimising inappropriate use. Studies assessing the economic impact of inappropriate antibiotic use in LMICs are lacking. We explored the economic impact of inappropriate antibiotic use using the example of upper respiratory tract infections (URIs) in Ghana, as part of the ABACUS (AntiBiotic ACcess and USe) project.

Methods: A top-down, retrospective economic impact analysis of inappropriate antibiotic use for URIs was conducted. Two inappropriate antibiotic use situations were considered: (1) URIs treated with antibiotics, against recommendations from clinical guidelines; and (2) URIs that should have been treated with antibiotics according to clinical guidelines, but were not. The analysis included data collected in Ghana during the ABACUS project (household surveys and exit-interviews among consumers buying antibiotics), scientific literature and stakeholder consultations. Included cost types related to health care seeking behaviour for URIs. Additionally, cost saving projections were computed based on potential effects of future interventions that improve antibiotic use.

Results: Health care costs related to inappropriate antibiotic use for URIs were estimated to be around 20 million (M) USD annually, including 18 M USD for situation 1 and 2 M USD for situation 2. Travel costs and lost income due to travel, together, were estimated to be around 44 M USD for situation 1 and 18 M USD for situation 2. Possible health care cost savings range from 2 to 12 M USD for situation 1 and from 0.2 to 1 M USD for situation 2.

Conclusions: This study indicates that inappropriate antibiotic use leads to substantial economic costs in a LMIC setting that could have been prevented. We recommend investment in novel strategies to counter these unnecessary expenditures. As the projections indicate, this may result in considerable cost reductions. By tackling inappropriate use, progress can be made in combatting antibiotic resistance.

Keywords: Antibiotic resistance; Economic impact analysis; Ghana; Inappropriate antibiotic use; Low and middle-income countries; Upper respiratory tract infection.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, Sumpradit N, et al. Antibiotic resistance-the need for global solutions. Lancet Infect Dis. 2013;13(12):1057–1098. doi: 10.1016/S1473-3099(13)70318-9. - DOI - PubMed
    1. Afari-Asiedu S, Oppong FB, Tostmann A, Ali Abdulai M, Boamah-Kaali E, Gyaase S, et al. Determinants of inappropriate antibiotics use in rural central Ghana using a mixed methods approach. Front Public Health. 2020;8:90. doi: 10.3389/fpubh.2020.00090. - DOI - PMC - PubMed
    1. Afari-Asiedu S, Kinsman J, Boamah-Kaali E, Abdulai MA, Gyapong M, Sankoh O, et al. To sell or not to sell; the differences between regulatory and community demands regarding access to antibiotics in rural Ghana. J Pharm Policy Pract. 2018;11(1):30. doi: 10.1186/s40545-018-0158-6. - DOI - PMC - PubMed
    1. Do NTT, Vu HTL, Nguyen CTK, Punpuing S, Khan WA, Gyapong M, et al. Community-based antibiotic access and use in six low-income and middle-income countries: a mixed-method approach. Lancet Global Health. 2021;9(5):E610–E619. doi: 10.1016/S2214-109X(21)00024-3. - DOI - PMC - PubMed
    1. Afari-Asiedu S, Hulscher M, Abdulai MA, Boamah-Kaali E, Asante KP, Wertheim HFL. Every medicine is medicine; exploring inappropriate antibiotic use at the community level in rural Ghana. BMC Public Health. 2020;20(1):1103. doi: 10.1186/s12889-020-09204-4. - DOI - PMC - PubMed

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