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Articles published until 12 December 2023 were explored using EconLit, EMBASE and PubMed. We focused on critical or high-priority bacteria, as defined by the WHO, and intervention costs and incremental cost-effectiveness ratio (ICER). Following Preferred Reporting Items for Systematic review and Meta-Analysis guidelines, we extracted unit costs, ICERs and essential study information including country, intervention, bacteria-drug combination, discount rates, type of model and outcomes. Costs were reported in 2022 US dollars ($), adopting the healthcare system perspective. Country willingness-to-pay (WTP) thresholds from Woods <jats:italic>et al<\/jats:italic> 2016 guided cost-effectiveness assessments. We assessed the studies reporting checklist using Drummond\u2019s method.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 20\u2009958 articles, 59 (32 pharmaceutical and 27 non-pharmaceutical interventions) met the inclusion criteria. Non-pharmaceutical interventions, such as hygiene measures, had unit costs as low as $1 per patient, contrasting with generally higher pharmaceutical intervention costs. Several studies found that linezolid-based treatments for methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> were cost-effective compared with vancomycin (ICER up to $21\u2009488 per treatment success, all 16 studies\u2019 ICERs&lt;WTP). Infection control measures such as hand hygiene and gown usage (ICER=$1160\/QALY or $4949 per ABR case averted, all ICERs&lt;WTP) and PCR or chromogenic agar screening for ABR detection were highly cost-effective (eg, ICER=$1206 and $1115 per life-year saved in Europe and the USA). Comparisons were hindered by within-study differences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Robust information on ABR interventions is critical for efficient resource allocation. We highlight cost-effective strategies for mitigating ABR in hospitals, emphasising substantial knowledge gaps, especially in low-income and middle-income countries. Our study serves as a resource for guiding future cost-effectiveness study design and analyses.<\/jats:p>\n                  <jats:p>\n                     <jats:bold>PROSPERO registration number<\/jats:bold> CRD42020341827 and CRD42022340064<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjgh-2023-013205","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T11:55:12Z","timestamp":1709207712000},"page":"e013205","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Costs-effectiveness and cost components of pharmaceutical and non-pharmaceutical interventions affecting antibiotic resistance outcomes in hospital patients: a systematic literature review"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2144-7181","authenticated-orcid":false,"given":"Kasim","family":"Allel","sequence":"first","affiliation":[{"name":"Disease Control Department, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"Institute for Global Health, University College London, London, UK"},{"name":"Department of Health and Community Sciences, University of Exeter, Exeter, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Hern\u00e1ndez-Leal","sequence":"additional","affiliation":[{"name":"Department of Community, Maternity and Paediatric Nursing, University of Navarra, Pamplona, Spain"},{"name":"Millennium Nucleus on Sociomedicine, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichola R","family":"Naylor","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"HCAI, Fungal, AMR, AMU & Sepsis Division, UK Health Security Agency, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo A.","family":"Undurraga","sequence":"additional","affiliation":[{"name":"Escuela de Gobierno, Pontificia Universidad Catolica de Chile, Santiago, Chile"},{"name":"CIFAR Azrieli Global Scholars program, Canadian Institute for Advanced Research, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6022-3036","authenticated-orcid":false,"given":"Gerard Joseph","family":"Abou Jaoude","sequence":"additional","affiliation":[{"name":"Institute for Global Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Bhandari","sequence":"additional","affiliation":[{"name":"Disease Control Department, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Flanagan","sequence":"additional","affiliation":[{"name":"Disease Control Department, London School of Hygiene & Tropical 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