Resistance to antibiotics: administrative response to the challenge.
The authors discuss antibiotic resistance within a conceptual framework that illustrates the dynamic relationships among antibiotic, patient, and population factors. The complexity of these interactions makes it unlikely that any single intervention or approach will adequately address the problem of increasing rates of antibiotic resistance. A case study focused on Streptococcus pneumoniae in the context of community-acquired pneumonia provides a detailed examination of the manner in which antibiotic use, expenditures, and microbial resistance are affected by an administrative reimbursement restriction implemented by a single government payer.
Marshall
Deborah A
DA
Research & Development, Health Economics & Outcomes Research, Innovus Research Inc., Burlington, Ontario, Canada. dmarshall@innovus.com
McGeer
Allison J
AJ
Jaszewski
Barbara A
BA
Grootendorst
Paul V
PV
Green
Karen A
KA
Laframboise
Melanie F
MF
Lam
Lee A
LA
Low
Donald E
DE
MacLeod
Stuart M
SM
D016527:Drug Costs / Q000706:statistics & numerical data; D004352:Drug Resistance, Microbial; D006801:Humans; D012051:Reimbursement Mechanisms; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D014481:United States