How to best control resistance is a controversial matter. Existing recommendations do not always agree and some recommendations are conflicting. One clear example is the key components of the Swedish intervention mentioned in Maya's recent post—isolation and contact tracing. In this specific study, children were isolated from day-care, sometimes up to a year. This type of intervention is not only related with economic costs, but also with the social costs of children being excluded from day-care and for the parents staying at home with the children. Determining the cost-benefit of one intervention versus another is not an easy task, and it is to date not clear whether the positive benefits of this intervention could have been achieved with less cost through some other intervention.
An interesting alternative intervention is the use of alcohol-based hand-disinfectant in addition to soap, which in another study performed in Swedish day-care centers was shown to reduce the rate of absenteeism from day-care due to infection by 12%. The economic benefits: an annual cut in the costs of $ 32 million for providing care for children at home due to illnesses. The costs: $ 1.7 million for hand-disinfection gel. Obviously a very cost-beneficial intervention. The question is just how the cost-benefits relate to the benefits of other interventions, such as vaccination.
Prioritizing intervention strategies to contain resistance and highlight policies that offer the greatest epidemiological impact at reasonable cost is one of the goals of the Global Antibiotic Resistance Partnership (GARP).