title: Economic consequences of the demography of MRSA patients and the impact of broad-spectrum antimicrobials.
abstract: BACKGROUND
  Studies have determined the societal impact of methicillin-resistant Staphylococcus aureus (MRSA) by modelling its impact on labour supply and productivity. In addition, most of the studies on the topic conclude that the problem of resistance should be counteracted on the macro level by reducing overall antibacterial consumption.
  
  
  OBJECTIVE
  Two major questions have been raised in the present work. Firstly, is MRSA impairing labour supply and productivity? Secondly, is it the overall use of antibacterials that may be seen as crucial to the spread of MRSA infections?
  
  
  METHODS
  The age distribution of MRSA patients is compared with the age distribution of the entire patient population at a German teaching hospital. In addition, the age distribution of MRSA patients was applied to the age distribution of the German population in the year 2050 in order to identify the effects of the double-ageing process on the spread of MRSA. Furthermore, recent epidemiological studies were reviewed on the impact of overall antibacterial consumption on MRSA infection rates.
  
  
  RESULTS
  Based on available data, we show that patients infected or colonized with MRSA are, for the most part, beyond retirement age and thus not responsible for changes in labour supply or productivity. Application of age distribution of MRSA patients to the age distribution of the German population in the year 2050 gives a 24% increase in the number of MRSA cases to a total of 182 778 due to an ageing population. In addition, we show that a 32% reduction in the cost of MRSA to the German healthcare system could be reached if use of fluoroquinolones and third-generation cephalosporins was reduced by just 10% and, correspondingly, use of antiseptics for hand disinfection was increased by 10%.
  
  
  CONCLUSIONS
  MRSA is a phenomenon that, to a larger degree, affects the elderly population rather than the labour force. When it comes to policy options to counteract MRSA on the macro level, most economic research on the topic is biased in assuming that the overall use of antibacterials is responsible for the spread of MRSA infections.
authors.affiliation: Research Center for Generational Contracts, Freiburg University, Freiburg, Germany. klaus.kaier@vwl.uni-freiburg.de
authors.forename: K
authors.initials: K
authors.lastname: Kaier
authors.forename: S
authors.initials: S
authors.lastname: Moog
mesh_terms: D017677:Age Distribution; D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects* / Q000191:economics / Q000592:standards; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control; D004363:Drug Utilization / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D004651:Employment / Q000191:economics / Q000706:statistics & numerical data; D005858:Germany / Q000453:epidemiology; D006235:Hand Disinfection / Q000592:standards; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects*; D011157:Population Dynamics; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000890:Anti-Infective Agents