Substantial Economic Burden Attributed to Recurrent Clostridium difficile

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The recurrence rate was significantly higher in patients who were female, were ≥65 years old, and used antibiotics.
The recurrence rate was significantly higher in patients who were female, were ≥65 years old, and used antibiotics.

According to the results of a recent study published in Clinical Infectious Diseases, mean healthcare costs attributable to primary Clostridium difficile infection were $24,205 per patient, and patients with recurrent C difficile infection had an additional $10,580 in infection-related healthcare costs.

To evaluate the economic burden of C difficile infection, researchers retrospectively analyzed insurance databases. Patients with a diagnosis of primary C difficile infection were propensity score matched to patients without C difficile infection to evaluate the costs attributable to primary infection. Similarly, patients with a diagnosis of recurrent C difficile infection were matched to patients with primary C difficile infection to determine the costs attributable to recurrent infection. The researchers compared cumulative hospitalized days, total healthcare costs, and healthcare costs within various settings during the 6 months after the index diagnosis between groups.

Among the 55,504 patients identified with C difficile infection, 24.8% were diagnosed with recurrent C difficile.

The researchers estimated that a mean of 5.20 hospitalized days could be attributed to primary C difficile infection, as patients with primary C difficile were hospitalized for an average of 8.01 days compared with 2.81 days in the matched cohort of patients without C difficile infection. Similarly, an average of 1.95 hospitalized days were attributable to recurrent C difficile compared with patients with primary infection.

The researchers concluded that "the [healthcare resource utilization] and economic burden associated with primary and [recurrent C difficile] are quite substantial. Better prevention and treatment of [C difficile], especially [recurrent C difficile], are needed."

Disclosure: All authors are employees of Merck & Co, Inc.


Zhang D, Prabhu VS, Marcella SW. Attributable healthcare resource utilization and costs for patients with primary and recurrent Clostridium difficile infection in the United States [published online January 19, 2018]. Clin Infect Dis. doi: 10.1093/cid/cix1021

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