Evaluation of the cost and length of hospital stays related to the management of an intestinal Clostridium difficile infection

Introduction : Intestinal Clostridium difficile Infection (CDI) treated in hospitals may concern patients whose reason for admission is CDI (primary diagnosis) or who have acquired CDI during their stay (secondary diagnosis). Objectives : The objective of this study is to evaluate the cost for social security and hospitals and the length of hospital stays related to CDIs as the main reason for admission. Method : This study was carried out in 2012 in 13 Belgian hospitals. Cases were selected by using diagnosis recorded in minimum discharge summaries. Pediatric stays are not part of the inclusion criteria (n= 86). Results : The average length of stay (standard deviation) was 13.53 days (11.95). The average cost (standard deviation) covered by social security/hospitals was €5,019.51 / €6,286.39 (9,638.42/ 6,368.45). 7% of patients were admitted to the Intensive Care Unit during hospitalization, for an average duration (standard deviation) of 8.18 days (2.93). The mortality rate was 8.1%. 19.8% of patients used vancomycin during the stay, 43% were treated with metronidazole only, 12.8% used vancomycin and metronidazole and 24.4% do not received vancomycin or metronidazole. No patients received fidaxomycin. Conclusion : This study made it possible to approach the cost of CDI as the main reason for admission. Such data should allow contributing to optimally assess both the pharmacoeconomic impact of the implementation of prevention strategies and also therapeutic management making use of more expensive medicinal products but associated with decreased risk of recurrence. (Acta gastroenterol. belg., 2018, 81, 263-268).