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The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis

1
Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
2
Global Health-Health Systems and Policy (HSP), Medicines, Focusing Antibiotics, Department of Public Health Sciences, Karolinska Institutet, 17177 Stockholm, Sweden
*
Author to whom correspondence should be addressed.
Antibiotics 2019, 8(3), 115; https://doi.org/10.3390/antibiotics8030115
Received: 9 July 2019 / Revised: 7 August 2019 / Accepted: 8 August 2019 / Published: 10 August 2019
Antibiotic resistance (ABR) is one of the biggest threats to global health, especially in China. This study aims to analyze the published literature on the clinical and economic impact of ABR or multi-drug resistant (MDR) bacteria compared to susceptible bacteria or non-infection, in mainland China. English and Chinese databases were searched to identify relevant studies evaluating mortality, hospital stay, and hospital costs of ABR. A meta-analysis of mortality was performed using a random effects model. The costs were converted into 2015 United States (US) dollars. Of 13,693 studies identified, 44 eligible studies were included. Twenty-nine investigated the impact of ABR on hospital mortality, 37 were focused on hospital stay, and 21 on hospital costs. Patients with ABR were associated with a greater risk of overall mortality compared to those with susceptibility or those without infection (odds ratio: 2.67 and 3.29, 95% confidence interval: 2.18–3.26 and 1.71–6.33, p < 0.001 and p < 0.001, respectively). The extra mean total hospital stay and total hospital cost were reported, ranging from 3 to 46 days, and from US$238 to US$16,496, respectively. Our study indicates that ABR is associated with significantly higher mortality. Moreover, ABR is not always, but usually, associated with significantly longer hospital stay and higher hospital costs. View Full-Text
Keywords: antibiotic resistance; multi-drug resistance; mortality; hospital stay; hospital cost; China antibiotic resistance; multi-drug resistance; mortality; hospital stay; hospital cost; China
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MDPI and ACS Style

Zhen, X.; Stålsby Lundborg, C.; Sun, X.; Hu, X.; Dong, H. The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis. Antibiotics 2019, 8, 115. https://doi.org/10.3390/antibiotics8030115

AMA Style

Zhen X, Stålsby Lundborg C, Sun X, Hu X, Dong H. The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis. Antibiotics. 2019; 8(3):115. https://doi.org/10.3390/antibiotics8030115

Chicago/Turabian Style

Zhen, Xuemei, Cecilia Stålsby Lundborg, Xueshan Sun, Xiaoqian Hu, and Hengjin Dong. 2019. "The Clinical and Economic Impact of Antibiotic Resistance in China: A Systematic Review and Meta-Analysis" Antibiotics 8, no. 3: 115. https://doi.org/10.3390/antibiotics8030115

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