Economic burden of @entity2718 associated XXXX : a cost-of-illness study from a German tertiary care hospital.

@entity1 @entity2176 @entity868 @entity294 @entity2718
PURPOSE: @entity2718 associated @entity294 (CDAD) is the most common cause of health-care-associated infectious @entity294 . In the context of the German health-care system, direct and indirect costs of an initial episode of CDAD and of CDAD recurrence are currently unknown. METHODS: We defined CDAD as presence of @entity294 (>= 3 unformed stools/day) in association with detection of @entity2718 toxin in an unformed faecal sample. @entity1 treated with @entity868 (PO or IV) and/or @entity2176 (PO) were included. Comprehensive data of @entity1 were retrospectively documented into a database using the technology of the Cologne Cohort of Neutropenic @entity1 (CoCoNut). @entity1 with CDAD were matched to control @entity1 in a 1:1 ratio. Analysis was split in three groups: incidence group (CDAD @entity1 without recurrence), recurrence group (CDAD @entity1 with >= 1 recurrence) and control group (matched non-CDAD @entity1 ). RESULTS: Between 02/2010 and 12/2011, 150 @entity1 with CDAD (114 @entity1 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  =  <0.001), resulting in mean overall direct treatment costs per @entity1 of    18,460 (95  %CI:    14,660-   22,270),    73,900 (95  %CI:    50,340-   97,460) and    14,530 (95  %CI:    11,730-   17,330; P  =  <0.001). 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  =  <0.001). CONCLUSIONS: Especially CDAD recurrence was associated with excessive costs, which were mostly attributable to a significantly longer overall length of stay. Innovative treatment strategies are warranted to reduce treatment costs and prevent recurrence of CDAD.
