Cost-Analysis of Adherence to Antimicrobial Guidelines as Part of Antimicrobial Stewardship Strategies in 6 Latin American Countries: A Pilot Experience Focusing on Economic Impact

Objectives: This study presents a pilot cost analysis and case-study comparison of adherence to antimicrobial stewardship (AMS) guidelines across 6 high-complexity healthcare institutions in Latin America and the Caribbean. It aims to evaluate the economic impact of adhering to these guidelines in hospitals implementing step-by-step processes to establish AMS programs within their institutions. Methods: A multicenter, retrospective, observational study was conducted in Argentina, Brazil, Chile, Costa Rica, United Mexican States, and Peru. A standardized Cost Report Form collected data on 2 comparable patients per institution, 1 treated according to AMS guidelines and 1 without adherence. Data included hospitalization days, intensive care unit costs, antibiotic use, and total management expenses, converted to US dollars. A sensitivity analysis varied key cost parameters (hospitalization, intensive care unit stays, and antibiotics) by 620% to assess cost stability. Results: Adherence to AMS guidelines led to hospitalization net cost reductions across all institutions: Peru (57.8%), Argentina (49.6%), United Mexican States (38.9%), Brazil (2.6%), Chile (10.2%), and Costa Rica (7.6%). Daily cost savings per patient ranged from US dollars $3 (Brazil) to $570 (Peru). Sensitivity analysis confirmed stability under varying conditions, with adjusted savings from $810 to $9.999. Conclusions: This case-study highlights the economic benefits of AMS adherence, including reduced hospitalization and antibiotic costs. Findings provide insights supporting AMS program expansion across Latin America and the Caribbean healthcare systems to optimize resources.