Healthcare resource utilization and direct medical costs associated with index and recurrent infection: A real-world data analysis.

: This study aimed to evaluate all-cause economic outcomes, healthcare resource utilization (HRU), and costs in patients with infection (CDI) and recurrent CDI (rCDI) using commercial claims from a large database representing various healthcare settings.: A retrospective analysis of commercial claims data from the IQVIA PharMetrics Plus™ database was conducted for patients aged 18-64 years with CDI episodes requiring inpatient stay with CDI diagnosis code or an outpatient medical claim for CDI plus a CDI treatment. Index CDI episodes occurred between 1/1/2010 and 6/30/2017, including only those where patients were observable 6 months before and 12 months after the index episode. Each CDI episode was followed by a 14-day claim-free period. rCDI was defined as another CDI episode within an 8-week window following the claim-free period. HRU, all-cause direct medical costs, and time to rCDI were calculated over 12 months and stratified by number of rCDI episodes.: 46,571 patients with index CDI were included. Mean time from one CDI episode to the next was approximately 1 month. In the 12-month follow-up period, those with no recurrence had 1.4 inpatient visits per person and those with 3 or more recurrences had 5.8. Most patients with 3 or more recurrences had 2 or more hospital admissions. The mean annual, total all-cause direct medical costs per patient were $71,980 for those with no recurrence and $207,733 for those with 3 or more recurrences.: The study included individuals 18 to 64 years only. A stringent definition of rCDI was used, which may have underestimated the incidence of rCDI.: CDI and rCDI are associated with substantial healthcare resource utilization and direct medical costs. Timing of recurrences can be predictable, providing a window of opportunity for interventions. Prevention of multiple rCDI appears essential to reduce healthcare costs.