With approximately 170,000 episodes of recurrent
C.diff
(≥1 recurrences)
annually, there is a profound impact on patients, clinics,
and the healthcare system overall1
Beyond symptoms, patients are concerned about recurrence and lost productivity
42% are very
worried about
getting sick again2*
26% miss work
even after
C. diff;
63 days on average3†
With recurrence,
patients come back
again and again
25% recur after primary
C. diff, and up to 65% of those
patients will recur again4-6
Patients average >15
office visits in the year
after recurrence7‡
Recurrences lead to
readmissions and increased
healthcare costs
About 50% will have
a
C. diff-related
hospital readmission8§
Managing
C. diff
recurrences
totals >$67,000 in healthcare
costs per patient per year9∥
* Telephone survey evaluated impact of recurrence on 119 patients with recurrent CDI (2 episodes within 15 to 46 days of each other and validated by medical record review).
† An observational study of 350 patients with self-reported CDI diagnosis completed an online survey. Of 235 patients with ≥1 past episodes of CDI, 26% stopped working afterward as a result for a median of 63 days (2–3000 days).
‡ Study to assess healthcare utilization based on records available for 95 patients with recurrent CDI from a single referral center in 2013.
§ In a retrospective cohort study of hospitalized patients, 196 of 413 patients were hospitalized within 6 weeks of completing their index C. diff antibacterial treatment or date of index hospitalization discharge, whichever occurred later.
|| A systematic literature review of 661 retrieved publications, 31 of which met all selection criteria, was conducted. Data were synthesized using a component-based cost approach to determine the per-patient, per-year RCDI-attributable direct medical costs.
Antibiotics do not restore the functionality of a disrupted
microbiome—a root cause of
C. diff
recurrence10-13
Broad-spectrum antibiotics
Beneficial bacteria
C. diff-specific antibiotics
Toxin-producing C. diff bacteria
C. diff spores
Disruption of the microbiome13-15
Treatment with broad-spectrum antibiotics can disrupt the gut microbiome, damaging the beneficial bacteria that defend against
C. diff
infection and potential recurrence
Onset of
C. diff
Infection10,13,15
Although standard-of-care
C. diff-specific antibiotics kill toxin-producing bacteria, dormant
C. diff
spores can remain
Increased risk of
C. diff
recurrence15
A favorable environment is created for unaffected dormant
C. diff
spores to rapidly germinate and grow
Broad-spectrum antibiotics
Beneficial bacteria
C. diff-specific antibiotics
Toxin-producing C. diff bacteria
C. diff spores
Jean needs standard-of-care antibiotics to kill the active C. diff infection…
…but patients like Jean remain at risk of recurrence because her microbiome is disrupted
REFERENCES: 1. Desai K, Gupta SB, Dubberke ER, et al. BMC Infect Dis. 2016;16(303):1-10. doi: 10.1186/s12879-016-1610-3. 2. Weaver FM, Trick WE, Evans CT, et al. Infect Control Hosp Epidemiol. 2017;38:1351-1357. doi.org/10.1017/ice.2017.208 3. Lurienne L, Bandinelli P-A, Galvain T, et al. J Patient Rep Outcomes. 2020;4:14. doi:10.1186/s41687-020-0179-1. 4. Kelly CP. Clin Microbiol Infect. 2012;18:21-27. doi.org/10.1111/1469-0691.12046. 5. Cornely OA, Miller MA, Louie TJ, Crook DW, Gorbach SL. Clin Infect Dis. 2012;55:S154-S161. doi: 10.1093/cid/cis462. 6. Nelson WW, Scott TA, Boules M, Teigland C, et al. J Man Care Spec Pharm. 2021:27:828-838. doi.org/10.18553/jmcp.2021.20395. 7. Rodrigues R, Barber GE, Ananthakrishnan AN. Infect Control Hosp Epidemiol. 2016;1-7. doi:10.1017/ice.2016.246. 8. Olsen MA, Yan Y, Reske KA, et al. Am J Infect Control. 2015;43(4):318-322. doi:10.1016/j.ajic.2014.12.020. 9. Reveles KR, Yang M, Garcia-Horton V, et al. Adv Ther. 2023;40:3104-3134. doi:10.1007/s12325-023-02498-x. 10. McGovern BH, Ford CB, Henn MR, et al. Clin Infect Dis. 2021;72(12):2132-2140. doi:10.1093/cid/ciaa387. 11. Theriot CM, Young VB. Ann Rev Microbiol. 2015;69:445-461. doi:10.1146/annurev-micro-091014-104115. 12. Budi N, Safdar N, Rose WE. FEMS Microbes. 2020;1(1):1-8. doi:10.1093/femsmc/xtaa001. 13. Chilton CH, Pickering DS, Freeman J. Clin Microbiol Infect. 2018;24(5):476-482. doi:10.1016/j.cmi.2017.11.017. 14. Vincent C, Miller MA, Edens TJ, et al. Microbiome. 2016;4(12):1-11. doi:10.1186/s40168-016-0156-3. 15. Khanna S, Sims M, Louie TJ, et al. Antibiotics. 2022;11(9):1234. doi:10.3390/antibiotics11091234.
