Chapter 2:
The Clinical Consequences
of Antibiotic Resistance
What Every Health Care Executive Should Know:
The Cost of Antibiotic Resistance
Thomas R. Talbot, MD MPH
Assistant Professor of Medicine and Preventive Medicine
Vanderbilt University School of Medicine
What is the Clinical Impact of Antibiotic Resistance?
Two 56 yr-old females with a history of diabetes mellitus (Mrs. X and Mrs. Y) undergo elective total knee replacement at your facility on the same day. Both procedures are uneventful and without intraoperative complications.
Post-operatively, both patients have a central venous catheter (CVC) placed to deliver post-operative fluids and pain medication.
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Chapter 3:
The Financial Impact
of Antibiotic Resistance
What Every Health Care Executive Should Know:
The Cost of Antibiotic Resistance
Keith Kaye, M.D., M.S.
How much did it cost your hospital last year to prevent and manage MDROs?
Mr. Johnson, a 65-year-old man, was admitted to your institution from a rehabilitation facility with chest pain. He underwent cardiac catheterization followed by a coronary artery bypass graft on hospital day 7. On hospital day 9, he became septic and required blood pressure support. Multidrug-resistant (MDR) Klebsiella pneumoniae were found in his blood and he was started on three antibiotics—the only three active against the pathogen.
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Chapter 5:
Antibiotic Stewardship
What Every Health Care Executive Should Know:
The Cost of Antibiotic Resistance
Paul Cook, M.D.
Is antibiotic misuse promoting the spread of MDROs and increasing costs at your hospital?
Dr. Anderson admitted an elderly nursing home patient to your hospital with pneumonia. He ordered blood cultures and an antibiotic (moxifloxacin), which the patient began three hours after admission. In spite of the antibiotic, the patient’s condition worsened. The microbiology reports were returned the next day and showed that the blood cultures were growing Pseudomonas aeruginosa resistant to moxifloxacin but susceptible to imipenem.
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