As Clostridium difficile creates a significant economic and morbidity burden for hospitals, researchers with Cleveland Clinic and the University of Texas School of Public Health in Houston sought to determine the most cost-effective treatment for the illness in a study published Feb. 21 in the journal Infection Control and Hospital Epidemiology.
For the study, researchers reviewed 14 previous C. diff studies conducted prior to August 2016. Elements of C. diff examined in the study included treatment cost, cure rates and infection recurrence rates, among other influential treatment cost factors.
Here are four study findings.
1. Fidaxomicin, a newer treatment for C. diff, was often the most cost-effective treatment, though the findings were not definitive, as results from the individual studies largely varied based on the nature of the infection.
2. For initial C. diff, treatment with fidaxomicin was more cost-effective than vancomycin or metronidazole in 2 of 3 studies.
3. For more severe initial C. diff, fidaxomicin was the most cost-effective in 2 of 3 studies. For recurrent C. diff infections, fidaxomicin proved most cost-effective in 3 of 5 studies.
4. However, researchers found fecal microbiota transplantation via colonoscopy to be most cost-effective in treating recurrent C. diff in 4 out of 4 studies.
"The cost-effectiveness of fidaxomicin compared with other pharmacologic therapies was not definitive for either initial or recurrent [C. diff]," wrote the study's authors. "Despite its high cost, FMT by colonoscopy may be a cost-effective therapy for recurrent [C. diff]. A consensus on model design and assumptions are necessary for future comparison of [C. diff] treatment."
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