ArticleInfectious diseases and therapy2025
Epidemiology and Course of Clostridioides difficile Infections in Germany: Retrospective Analysis of German Health Claims Data.
Article in Infectious diseases and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionClostridioides difficile infection (CDI) is the leading cause of healthcare-associated infectious diarrhea, with recurrence rates of 15-20% after standard treatment and ≥ 30% after a second relapse. In Germany, reliable epidemiological data remain limited.
methodsA retrospective claims data analysis of the period 2017-2022 was performed using the German Analysis Database for Evaluation and Health Services Research (DADB), which covers 4.1 million insured individuals. Incident CDI cases, recurrent cases, and mortality were assessed and stratified by diagnosis setting. A propensity-score-matched control group without CDI adjusted for age, sex, and comorbidities was created. Cox proportional hazards models were used to determine mortality risk factors.
resultsCDI incidence decreased from 119 to 66 per 100,000 (2017-2022). First-recurrence rate declined from 15% to 11% and second-recurrence rate from 20% to 15%. Of all recurrences, 43% were managed in the outpatient setting. In 2022, severe CDI accounted for 38% of extrapolated statutory health insurance (SHI) cases. Metronidazole use in outpatients decreased from 79% to 53% for incident cases, while vancomycin prescriptions increased from 18% to 39%. In 2022, 72% of first CDI recurrences were treated with vancomycin, 20% with metronidazole, and 2% with fidaxomicin. Despite guideline recommendations, only 8% of patients with a second recurrence received fidaxomicin. In 2021, the 30-day mortality rate for secondary inpatient CDI cases was 20%, compared with 8% for primary inpatient cases and 4% for outpatient cases. Corresponding 1-year mortality rates were 44%, 32%, and 16%. In patients with CDI, 1-year mortality was 1.9 to 2.1 times higher than in controls (p < 0.001), with advanced age (≥ 65 years) being the strongest predictor (hazard ratio [HR] 12.21; 95% confidence interval [CI] 10.91-13.67).
conclusionsDespite declining incidence and recurrence rates, CDI remains a major health burden in Germany, especially for older adults. High severity, limited adherence to treatment guidelines, and excess mortality underscore the need for targeted prevention, individualized therapy, and improved guideline implementation.
Indexed as
Identifiers
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.