The Growing Importance of Reserve Antibiotics in Organ Transplant Care and the Role of Timely Appropriate Antibiotic Treatment to Preserve the Benefits of Prior Health Investments
Author(s)
Priya Shastri, MSc1, Merel Gijsen, MSc2, Floortje Van Nooten, PhD2.
1Shionogi B.V., Paddington, United Kingdom, 2Shionogi B.V., Amsterdam, Netherlands.
1Shionogi B.V., Paddington, United Kingdom, 2Shionogi B.V., Amsterdam, Netherlands.
OBJECTIVES: The growing threat of antimicrobial resistance (AMR) and the increasing prevalence of multi-drug resistant (MDR) infections present significant challenges for solid organ transplant (SOT) recipients. This review examines the burden of AMR in SOT patients, explores management strategies, and assesses the financial implications, weighing the cost-benefit against the initial investment in SOT.
METHODS: A focused targeted literature review identified 14 publications from a 5-year period (2020- 2025) using PubMed and Google Scholar. Cost data were extracted from public databases
RESULTS: Post-SOT prevalence of MDR infections affected up to 28.6%, with mortality rates reaching 40%. Extended-spectrum beta-lactamase (ESBL)-producing bacteria were the most prevalent MDR pathogens, particularly among kidney transplant (KT) recipients. The cost of a KT in four European countries ranged from €19,570 to €52,083, while antibiotic treatments for MDR infections varied between €1,200 and €9,500 (based on 10 days of treatment). Inappropriate initial therapy of MDR infections contribute to prolonged and costly hospital stays. Several studies highlight the importance of timely identification of the appropriate antibiotic therapy to improve survival rates and minimize costs associated with ineffective treatment while safeguarding prior healthcare investments. Rapid diagnostics can improve treatment outcomes but are not routinely practiced. In the absence of rapid diagnostics, initiating broader-spectrum antibiotics for at-risk patients and adjusting therapy based on diagnostic results may be appropriate.
CONCLUSIONS: Although rapid diagnostics and empiric antibiotic therapy require additional upfront costs, they play a vital role in preserving prior investments, such as the SOT. Current antibiotic assessment frameworks like Spectrum, Transmission, Enablement, Diversity, and Insurance may not fully account for these benefits, underscoring the need for more comprehensive value assessments for antibiotics.
METHODS: A focused targeted literature review identified 14 publications from a 5-year period (2020- 2025) using PubMed and Google Scholar. Cost data were extracted from public databases
RESULTS: Post-SOT prevalence of MDR infections affected up to 28.6%, with mortality rates reaching 40%. Extended-spectrum beta-lactamase (ESBL)-producing bacteria were the most prevalent MDR pathogens, particularly among kidney transplant (KT) recipients. The cost of a KT in four European countries ranged from €19,570 to €52,083, while antibiotic treatments for MDR infections varied between €1,200 and €9,500 (based on 10 days of treatment). Inappropriate initial therapy of MDR infections contribute to prolonged and costly hospital stays. Several studies highlight the importance of timely identification of the appropriate antibiotic therapy to improve survival rates and minimize costs associated with ineffective treatment while safeguarding prior healthcare investments. Rapid diagnostics can improve treatment outcomes but are not routinely practiced. In the absence of rapid diagnostics, initiating broader-spectrum antibiotics for at-risk patients and adjusting therapy based on diagnostic results may be appropriate.
CONCLUSIONS: Although rapid diagnostics and empiric antibiotic therapy require additional upfront costs, they play a vital role in preserving prior investments, such as the SOT. Current antibiotic assessment frameworks like Spectrum, Transmission, Enablement, Diversity, and Insurance may not fully account for these benefits, underscoring the need for more comprehensive value assessments for antibiotics.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE709
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Health Technology Assessment
Topic Subcategory
Novel & Social Elements of Value
Disease
Infectious Disease (non-vaccine), Urinary/Kidney Disorders