Economic burden of Emphasis Type="Italic"Clostri

Authors: S M Heimann J J Vehreschild O A Cornely H Wisplinghoff M Hallek R Goldbrunner B W Böttiger T Goeser A Hölscher S Baldus F Müller N Jazmati S Wingen B Franke M J G T Vehreschild

Publish Date: 2015/06/30

Volume: 43, Issue: 6, Pages: 707-714

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Abstract

Clostridium difficile associated diarrhoea CDAD is the most common cause of healthcareassociated infectious diarrhoea In the context of the German healthcare system direct and indirect costs of an initial episode of CDAD and of CDAD recurrence are currently unknownWe defined CDAD as presence of diarrhoea ≥3 unformed stools/day in association with detection of Clostridium difficile toxin in an unformed faecal sample Patients treated with metronidazole PO or IV and/or vancomycin PO were included Comprehensive data of patients were retrospectively documented into a database using the technology of the Cologne Cohort of Neutropenic Patients CoCoNut Patients with CDAD were matched to control patients in a 11 ratio Analysis was split in three groups incidence group CDAD patients without recurrence recurrence group CDAD patients with ≥1 recurrence and control group matched nonCDAD patientsBetween 02/2010 and 12/2011 150 patients with CDAD 114 patients in the incidence and 36 24  in the recurrence group and 150 controls were analysed Mean length of stay was 32 95 CI 30–37 94 95 CI 76–112 and 24 days 95 CI 22–27 P = 0001 resulting in mean overall direct treatment costs per patient of €18460 95 CI €14660–€22270 €73900 95 CI €50340–€97460 and €14530 95 CI €11730–€17330 P = 0001 In the incidence and recurrence group the mean cumulative number of antibiotic CDAD treatment days was 11 95 CI 10–12 and 36 95 CI 27–45 P = 0001SMH has received research and travel grants from Astellas Gilead and Merck and travel grants from Pfizer OAC was supported by the German Federal Ministry of Research and Education BMBF grant 01KN1106 received research grants from 3M Actelion Astellas Basilea Bayer Celgene Cubist/Optimer Genzyme Gilead GSK Merck/MSD Miltenyi Pfizer Quintiles Shionogi Viropharma was a consultant to 3M Astellas Basilea Cidara Cubist/Optimer Da Volterra Daiichi Sankyo F2G Genentech Gilead GSK Merck/MSD Merck Serono Pfizer Rempex Sanofi Pasteur and Summit/Vifor and received lecture honoraria from Astellas Gilead Merck/MSD and Pfizer JJV was supported by the German Federal Ministry of Research and Education BMBF grant 01KI0771 and the German Centre for Infection Research JJV has received research grants from Astellas Gilead Sciences Infectopharm Merck/MSD and Pfizer and served on the speakers’ bureau of Astellas Merck/MSD Gilead Sciences and Pfizer MJGTV has served at the speakers’ bureau of Pfizer Merck/MSD Gilead Sciences and Astellas Pharma received research funding from 3M Astellas Pharma and Gilead Sciences and was a consultant to Berlin Chemie

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