Recurrent C. diff Infection Burden

Recurrent C. diff Infection

Affects Patient Quality of Life, Hospital Quality Metrics, and Reimbursement

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C. diff infection recurs in up to 35% of cases within 8 weeks after initial C. diff infection diagnosis.1, 2

Recurrent C. diff infection significantly affects hospital quality metrics and reimbursement.
57% of patients with at least one CDI recurrence experienced ≥2 hospital admissions within 12 months.
Hospitalizations average 18 days for patients with recurrent CDI. The total, all-cause, and direct medical costs during 12-month period after initial C. diff infection can range from $131K to $207K.3,4

Total, all-cause, direct medical costs during 12-month period after initial C. diff infection
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Total, all-cause, direct medical costs during 12-month period after initial C. diff infection.4


Recurrence accounts for some 75,000 to 175,000 additional cases of C. diff infections per year in the United States.5,6 Furthermore, patients who have had a recurrence are at a higher risk of further C. diff infections.7

After the first recurrence, it has been estimated that up to 60% of patients may develop a subsequent recurrence.3,8-11

In fact, one observational analysis found that 85% of patients with recurrent C. diff infection will have a C. diff infection-related readmission within 12 months.12

A systematic literature

A systematic literature review found that patients with 3 or more recurrences had a mean of 5.8 inpatient visits per patient in a 12-month follow-up period.4



  1. Lessa FC, Mu Y, Bamberg WM, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372(9):825-834.
  2. Cornely OA, Miller MA, Louie TJ, Crook DW, Gorbach SL. Treatment of first recurrence of Clostridium difficile infection: fidaxomicin versus vancomycin. Clin Infect Dis. 2012;55(suppl 2):s154-s161.
  3. Nelson WW, Scott TA, Boules M, et al. Health care resource utilization and costs of recurrent Clostridioides difficile infection in the elderly: a real-world claims analysis [published online March 11, 2021]. J Manag Care Spec Pharm. 2021;1-11. doi:10.18553/jmcp.2021.20395
  4. Feuerstadt P, Stong L, Dahdal DN, Sacks N, Lang K, Nelson WW. Healthcare resource utilization and direct medical costs associated with index and recurrent Clostridioides difficile infection: a real-world data analysis. J Med Econ. 2020;23(6):603-609.
  5. Burton HE, Mitchell SA, Watt M. A systematic literature review of economic evaluations of antibiotic treatments for Clostridium difficile infection. Pharmacoeconomics. 2017;35(11):1123-1140.
  6. Shields K, Araujo-Castillo R V, Theethira TG, Alonso CD, Kelly CP. Recurrent Clostridioides difficile infection: from colonization to cure. Anaerobe. 2015;34:59-73. 2008;320(5883):1647-1651.
  7. Vincent Y, Manji A, Gregory-Miller K, Lee C. A review of management of Clostridioides difficile infection: primary recurrence. Antibiotics (Basel). 2015;4(4):411-423.
  8. Leong C, Zelenitsky S. Treatment strategies for recurrent Clostridioides difficile infection. Can J Hosp Pharm. 2013;66(6):361-368.
  9. Kelly CP. Can we identify patients at high risk of recurrent Clostridium difficile infection? Clin Microbiol Infect. 2012;18(suppl 6):21-27.
  10. Riddle DJ, Dubberke ER. Clostridium difficile infection in the intensive care unit. Infect Dis Clin North Am. 2009;23(3):727-743.
  11. Smits WK, Lyras D, Lacy DB, Wilcomx MH, Kuiiper EJ. Clostridium difficile infection. Nat Rev Dis Primers. 2016;2(16020):1-47.
  12. Rodrigues R, Barber GE, Ananthakrishnan AN. A comprehensive study of costs associated with recurrent Clostridioides difficile infection. Infect Control Hosp Epidemiol. 2017;38(2):196-202.