Attributable Inpatient Costs of Recurrent Clostridium difficile Infections

Objective.To determine the attributable inpatient costs of recurrent Clostridium difficile infections (CDIs)Design.Retrospective cohort study.Setting.Academic, urban, tertiary care hospital.Patients.A total of 3,958 patients aged 18 years or more who developed an initial CDI episode from 2003 through 2009.Methods.Data were collected electronically from hospital administrative databases and were supplemented with chart review. Patients with an index CDI episode during the study period were followed up for 180 days from the end of their index hospitalization or the end of their index CDI antibiotic treatment (whichever occurred later). Total hospital costs during the outcome period for patients with recurrent versus a single episode of CDI were analyzed using zero-inflated lognormal models.Results.There were 421 persons with recurrent CDI (recurrence rate, 10.6%). Recurrent CDI case patients were significantly more likely than persons without recurrence to have any hospital costs during the outcome period (P < .001). The estimated attributable cost of recurrent CDI was $11,631 (95% confidence interval, $8,937–$14,588).Conclusions.The attributable costs of recurrent CDI are considerable. Patients with recurrent CDI are significantly more likely to have inpatient hospital costs than patients who do not develop recurrences. Better strategies to predict and prevent CDI recurrences are needed.Infect Control Hosp Epidemiol 2014;35(11):1400–1407

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Adherence to Clostridium difficile Infection Treatment Guidelines at a Tertiary Care Hospital: A Retrospective Chart Review

Gastroenterology ◽

10.1053/j.gastro.2016.05.032 ◽

2016 ◽

Vol 151 (1) ◽

pp. 198-199

Author(s):

Christine Granato ◽

Xiang Lu ◽

Sally Thurston ◽

Danielle Marino

Keyword(s):

Clostridium Difficile ◽

Clostridium Difficile Infection ◽

Chart Review ◽

Treatment Guidelines ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Retrospective Chart Review ◽

Care Hospital ◽

Infection Treatment

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Containing Cefoxitin Costs through a Program to Curtail Use in Surgical Prophylaxis

Canadian Journal of Infectious Diseases ◽

10.1155/1993/875916 ◽

1993 ◽

Vol 4 (5) ◽

pp. 275-278 ◽

Cited By ~ 5

Author(s):

Geoffrey Taylor ◽

Edith Blondel-Hill ◽

Pamela Kibsey ◽

Erwin Friesen ◽

Ronald Tisdell ◽

...

Keyword(s):

Chart Review ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Hospital Costs ◽

Care Hospital ◽

Surgical Prophylaxis ◽

Pharmacy Records ◽

Pharmacy And Therapeutics Committee ◽

Before And After ◽

Acquisition Costs

Objective: To reduce drug costs attributable to anti-anaerobic cephalosporins – specifically to reduce cefoxitin use in surgical prophylaxis.Design: Before and after intervention cefoxitin use comparison.Setting: Tertiary care hospital.Participants: Hospitalized patients.Interventions: Chart review of patients identified through pharmacy records as cefoxitin recipients was carried out to determine which physicians were the principal users of cefoxitin and the purpose for such use. These data were used to direct cost containment strategies.Main Outcome Measures: Hospital quarterly pharmacy acquisition costs and grams of cefoxitin used.Results: The departments of surgery (49%) and obstetrics/gynecology (37%) were the principal users of cefoxitin, and surgical prophylaxis was found to be the principal indication for use (63%). These departments were invited by the Antibiotic Utilization Subcommittee of the hospital’s Pharmacy and Therapeutics Committee to draft surgical prophylaxis guidelines in keeping with published recommendations. Such guidelines were written and distributed to medical staff and substituted cefazolin for most forms of prophylaxis, gentamicin/metronidazole for colorectal prophylaxis and cefoxitin only for appendectomies. Over the following 21 months, hospital-wide cefoxitin use fell from 6093 g, $70,076 per quarter, to 1316 g, $11,515 per quarter (partially offset by a 2595 g, $9,131 per quarter increase in cefazolin use).Conclusion: As a first step in reducing hospital costs of anti-anaerobic cephalosporins, rationalization of cefoxitin use may be preferable to formulary interchange with alternatives such as ceftizoxime or cefotetan.

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