OBJECTIVES: Bacterial resistance is one of the major causes of mortality and costs in all healthcare systems. Narrow-spectrum beta-lactams, like temocillin, are recommended to spare the use of broad-spectrum antibiotics in order to decrease their selection pressure for resistant organisms. Considering the positive correlation between consumption of antibacterials and related bacterial resistance, the present research aims to explore the budget impact of introducing temocillin in Iran as part of an antibiotic stewardship program to spare the use of carbapenems such as imipenem.

METHODS: The historical trend of imipenem-resistant Pseudomonas in Iran was detected by systematic review and pooled analysis of reporting articles. It was assumed that temocillin takes 10% of imipenem market share after its launch and this market share will increase linearly into 30% within 5 years. A budget impact model was developed in MS Excel adjusting the diminishing consumption of imipenem in Define Daily Doses (DDD)/capita with the prevalence of imipenem-resistant Pseudomonas