title: An economic evaluation of Clostridium difficile infection management in an Italian hospital environment.
abstract: OBJECTIVE
  Clostridium difficile infection (CDI) accounts for the majority of nosocomial cases of diarrhea, and with recent upsurge of multidrug-resistant strains, morbidity and mortality have increased. Data on clinical impact of CDI come mostly from Anglo-Saxon countries, while in Italy only two studies address the issue and no economic data exist on costs of CDI in the in hospital setting. A retrospective cross-sectional study with pharmacoeconomic analysis was performed on the CDI series of the Policlinico Gemelli of Rome, a major 1400 bed Hospital.
  
  
  METHODS
  The clinical charts of 133 patients in a 26 month period were reviewed. All costs of the involved resources were calculated and statistical analysis was carried out with means and standard deviations, and categorical variables as number and percentages.
  
  
  RESULTS
  The results show the significant sanitary costs of CDI in an Italian hospital setting. The cost analysis of the various elements (exams, imaging studies, therapies, etc.) shows that none independently influences the high cost burden of CDI, but that it is the simple length of hospital stay that represents the most important factor.
  
  
  CONCLUSIONS
  Prevention of CDI is the most cost-effective approach. The major break-through in cost reduction of CDI would be a therapeutical intervention or procedure that shortens hospital length of stay.
authors.affiliation: Department of Surgery, Catholic University of the Sacred Heart, Rome, Italy. sabina.magalini@rm.unicatt.it
authors.forename: S
authors.initials: S
authors.lastname: Magalini
authors.forename: G
authors.initials: G
authors.lastname: Pepe
authors.forename: S
authors.initials: S
authors.lastname: Panunzi
authors.forename: P L
authors.initials: PL
authors.lastname: Spada
authors.forename: A
authors.initials: A
authors.lastname: De Gaetano
authors.forename: D
authors.initials: D
authors.lastname: Gui
mesh_terms: D000328:Adult; D000368:Aged; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000628:therapy*; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies