Antimicrobial resistance to eight bacteria of public health concern cost the health service an additional €12 million in extra hospital bed days in 2019

Date of publication:

The Health Information and Quality Authority (HIQA) has today published its report on the economic burden of antimicrobial resistant infections on Irish public acute hospitals in 2019.

Antimicrobial resistance (AMR) is a global public health concern; it is defined as the ability of a micro-organism (for example, a bacterium) to stop an antimicrobial from working against it. AMR is driven largely by excessive and inappropriate use of antimicrobials in human and animal populations. As a result of AMR, treatment options become limited and common infections become more difficult and expensive to treat.

At the request of the Department of Health, HIQA undertook an analysis of the hospital costs associated with AMR. This work, part funded by the Health Research Board, supports Ireland’s First National Action Plan (iNAP) on Antimicrobial Resistance.

HIQA’s work included a literature review to inform an economic assessment of AMR. The subsequent analysis estimated the costs associated with eight selected antimicrobial-resistant bacteria of public health concern. HIQA found that over 4,700 of these resistant bacterial infections occurred across 50 public acute hospitals in Ireland in 2019. The study estimated that AMR associated with these bacteria cost the health service an additional €12 million in extra hospital bed days in 2019. HIQA also found that these resistant infections resulted in about 215 deaths and almost 5,000 DALYs, or years of full health lost.

Dr Máirín Ryan, HIQA’s Deputy CEO and Director of Health Technology Assessment, said: “Antimicrobial resistance also places a significant burden, both health and financial, on patients, carers and families. We estimated that AMR associated with these selected bacteria resulted in almost 5,000 DALYs in patients in 2019. To put this in context, this is similar to the burden reported in Ireland for certain cancers and rheumatoid arthritis.”

There are other important resistant micro-organisms and additional costs associated with managing AMR beyond extra bed days that were not examined in this study, due to the lack of available data. The estimated €12 million is therefore an underestimate of the total annual cost of managing all resistant infections in Ireland.

Dr Ryan continued: “There is a need for enhanced surveillance of AMR in Ireland. Enhanced surveillance and expanded public health capacity would enable earlier identification and management of AMR threats, as well as inform investment decisions by the Department of Health and the HSE.”

You can find the report from the link at the top of the page.


Further information:
Marty Whelan, Head of Communications & Stakeholder Engagement
01 814 7480/085 805 5202,

Notes to Editor:

  • HIQA has today published its report entitled “Economic burden of antimicrobial resistance: An analysis of additional costs associated with resistant infections”
  • This costing study was undertaken in fulfilment of listed activities aligned with Strategic Objective 5 of Ireland’s National Action Plan (iNAP) on Antimicrobial Resistance (2017-2020).
  • Two research questions were conducted as part of this study: a literature review of methodological approaches to cost AMR in acute hospital settings and an economic analysis.
  • Widely diverging cost estimates have been reported in the literature, so the true burden of AMR is unclear. The HIQA review found that there is not a universally accepted, or gold standard, approach to costing AMR. This reflects differences in the way health and social care is provided internationally as well as differences in the way in which cost and resource use data are collected.
  • Findings from this current study provide a baseline cost estimate upon which future iterations of this study can build, and have informed the development of the second National Action Plan on Antimicrobial Resistance 2021-2025, iNAP 2.
  • HIQA’s Evidence for Policy Team, who conducted this study, is responsible for the effective implementation of evidence synthesis programmes to deliver high-quality research to support policy development by the Department of Health.
  • An expert advisory group (EAG) was convened for this study, comprising representation from key stakeholders including clinical experts, policy makers, service providers, patients and methodological experts. The role of the EAG was to inform the process and provide expert advice.
  • This research was part-funded through an extension of the grant agreement by the Health Research Board (HRB) for the HRB-Collaboration in Ireland for Clinical Effectiveness Reviews (HRB-CICER 2016-1871). The HRB supports excellent research that improves people’s health, patient care and health service delivery. The HRB aims to ensure that new knowledge is created and then used in policy and practice. In doing so, the HRB supports health system innovation and creates new enterprise opportunities.