OBJECTIVES : To calculate the cost savings by reduction of anti microbial resistance (AMR) bacteria from a shift to alcohol based hand rub from soap based hand hygiene practices using a health economic model.

METHODS : A decision analytic model was created to simulate a cohort of patients who used soap based hand hygiene and later shift to alcohol based hand rub. This enabled to demonstrate the savings from hand-wash to hand-rub using an alcohol based hand sanitizer.

RESULTS : Evidence from published literature showed that Gram –ve multi drug resistant bacteria are a conspicuous burden in Indian ICUs compared to Gram +ve bacteria which are proportionately higher in western intensive care units (ICUs). The health economic model demonstrated that the approximate savings from the shift was 64% in a deterministic mode and 62.73% in a probabilistic mode, considering overall direct medical costs; 62% in a deterministic mode and 62.64% in a probabilistic mode, considering antibiotic costs; 65% in a deterministic mode and 62.3% in a probabilistic mode, considering total pharmacy costs. There was a 3 fold saving in the alcohol based hand hygiene approach compared to soap based hand hygiene approach considering overall direct medical costs or total pharmacy costs or antibiotic costs. The savings were driven by reduction in costs related to management of infections due to AMR bacteria.

CONCLUSIONS : The results demonstrate that economic burden due to Gram –ve AMR bacteria can be reduced considerably in Indian healthcare setting if hand washing is replaced by hand rubbing with alcohol based hand rubs.