ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2014
Cost-effectiveness of competing strategies for management of recurrent Clostridium difficile infection: a decision analysis.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02255305 (Fecal Microbiota Transplantation Versus Standard Medical Therapy for Initial Treatment of Recurrent Clostridium Difficile Infection), which is not on this map. Cited by 66 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Fecal Microbiota Transplantation Versus Standard Medical Therapy for Initial Treatment of Recurrent Clostridium Difficile Infection
Who cites it
66 citing papers in PubMed, 3 syntheses or guidelines pooled it, 152 citations in OpenAlex.
- Alternative treatment of recurrentFrontiers in microbiology · 2024Pooled it
- Cost-Effectiveness of Competing Treatment Strategies for Clostridium difficile Infection: A Systematic Review.Infection control and hospital epidemiology · 2018Pooled it
- A Systematic Literature Review of Economic Evaluations of Antibiotic Treatments for Clostridium difficile Infection.PharmacoEconomics · 2017Pooled it
- Cost-Effectiveness of Hospital-at-Home and Fecal Microbiota Transplantation in Treating Older Patients With Clostridioides difficile.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Trial
- Codeveloping a Clinical Pathway for Recurrent Clostridioides difficile Infection With Primary Care Providers: User-Centered Design Study.Interactive journal of medical research · 2026Article
- Clinical and Pharmacoeconomic evaluation of Fidaxomicin in patients over 65 years of age and immunocompromised patients with recurrent and refractory Clostridioides difficile infection.BMC infectious diseases · 2026Article
- Increasing patient access to faecal microbiota transplantation with remote delivery: a cost analysis of outpatient versus home-based treatment.Health economics review · 2025Article
- Cost-Effectiveness Analysis of Antimicrobial Prescribing in the Treatment of Clostridioides Difficile Infection in England.PharmacoEconomics - open · 2023Article
- Graph convolutional network-based fusion model to predict risk of hospital acquired infections.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Fecal microbiota transplantation for treatment of refractory or recurrentFrontiers in medicine · 2023Article
- Risk Factors, Diagnosis, and Management ofMicroorganisms · 2022Review
- Fecal Microbiota Transplantation for Recurrent C difficile Infection During the COVID-19 Pandemic: Experience and Recommendations.Mayo Clinic proceedings · 2021Article
- Health economic evaluations comparing faecal microbiota transplantation with antibiotics for treatment of recurrent Clostridioides difficile infection: a systematic review.Health economics review · 2021Review
- Economic burden and cost-effectiveness of therapies forTherapeutic advances in gastroenterology · 2021Review
- Fecal microbiota transplantation for recurrentTherapeutic advances in gastroenterology · 2021Review
- Navigating changes inJournal of managed care & specialty pharmacy · 2020Review
- Evaluation of the Cost-effectiveness of Infection Control Strategies to Reduce Hospital-Onset Clostridioides difficile Infection.JAMA network open · 2020Article
- Economic evaluation of Faecal microbiota transplantation compared to antibiotics for the treatment of recurrentEClinicalMedicine · 2020Article
- Fecal Transplants by Colonoscopy and Capsules Are Cost-Effective Strategies for Treating Recurrent Clostridioides difficile Infection.Digestive diseases and sciences · 2020Article
- Cost-Effectiveness Analysis of Four Common Diagnostic Methods for Clostridioides difficile Infection.Journal of general internal medicine · 2020Article
6 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundClostridium difficile infection (CDI) is an important cause of morbidity and healthcare costs, and is characterized by high rates of disease recurrence. The cost-effectiveness of newer treatments for recurrent CDI has not been examined, yet would be important to inform clinical practice. The aim of this study was to analyze the cost effectiveness of competing strategies for recurrent CDI.
methodsWe constructed a decision-analytic model comparing 4 treatment strategies for first-line treatment of recurrent CDI in a population with a median age of 65 years: metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplant (FMT). We modeled up to 2 additional recurrences following the initial recurrence. We assumed FMT delivery via colonoscopy as our base case, but conducted sensitivity analyses based on different modes of delivery. Willingness-to-pay threshold was set at $50 000 per quality-adjusted life-year.
resultsAt our base case estimates, initial treatment of recurrent CDI using FMT colonoscopy was the most cost-effective strategy, with an incremental cost-effectiveness ratio of $17 016 relative to oral vancomycin. Fidaxomicin and metronidazole were both dominated by FMT colonoscopy. On sensitivity analysis, FMT colonoscopy remained the most cost-effective strategy at cure rates >88.4% and CDI recurrence rates <14.9%. Fidaxomicin required a cost <$1359 to meet our cost-effectiveness threshold. In clinical settings where FMT is not available or applicable, the preferred strategy appears to be initial treatment with oral vancomycin.
conclusionsIn this decision analysis examining treatment strategies for recurrent CDI, we demonstrate that FMT colonoscopy is the most cost-effective initial strategy for management of recurrent CDI.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.