Evidence map›Paper›PMID 41612217›Full record

ArticleBMC infectious diseases2026

Clinical and Pharmacoeconomic evaluation of Fidaxomicin in patients over 65 years of age and immunocompromised patients with recurrent and refractory Clostridioides difficile infection.

Isabella Alram, Sebastian M Wingen-Heimann, Marie Engelhard, Nele Pfeiffer, J Janne Vehreschild, Maria J G T Vehreschild, Sina M Pütz

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Isabella Alram *Department II of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany.
Sebastian M Wingen-Heimann *Institute of Translational Research, Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
Marie EngelhardDepartment I of Internal Medicine, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany.
Nele PfeifferDepartment I of Internal Medicine, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany.
J Janne VehreschildFaculty of Medicine, Institute for Digital Medicine and Clinical Data Science, Goethe University Frankfurt, Frankfurt am Main, Germany.
Maria J G T VehreschildDepartment II of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany.
Sina M PützDivision of Infectious Diseases, Department I of Internal Medicine, Faculty of Medicine, University of Cologne, University Hospital Cologne, Cologne, Germany. sina.puetz@uk-koeln.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecurrent or refractory Clostridioides difficile infection (CDI) often affects older and immunocompromised patients, posing clinical and economic challenges. While fidaxomicin has shown lower recurrence rates than vancomycin in the general population, evidence in this population remains limited.

methodsThis retrospective, multicentre case-control study compared patients aged > 65 years or immunocompromised patients receiving fidaxomicin (case group) with those treated with vancomycin (control group) for recurrent or refractory CDI. A microcosting approach was used to assess direct treatment costs.

resultsA total of 344 patients were included (172 per group). Compared to the control group, the fidaxomicin group presented a significantly higher rate of symptom reduction on day 10 (n = 163, 95% vs. n = 147, 86%; p = 0.004) and lower CDI recurrence rates (n = 36, 21% vs. n = 63, 37%; p = 0.001). While the mean CDI treatment costs per patient were significantly higher in the fidaxomicin group (p < 0.001), the hospitalisation and overall treatment costs were comparable (€19,898, 95% CI €16,151-€23,645 vs. €20,469, 95% CI €16,837-€24,101, p = 0.811; €17,798, 95% CI €14,620-€20,975 vs. €17,300, 95% CI €14,199-€20,400, p = 0.840). Key cost drivers were hospitalisation, intensive care unit treatment, and severe initial CDI.

conclusionsDespite higher drug acquisition costs of fidaxomicin, overall treatment costs were comparable between the two groups with better clinical outcomes in patients treated with fidaxomicin. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Anti-Bacterial AgentsClostridium InfectionsFidaxomicinImmunocompromised HostAgedAged, 80 and overCase-Control StudiesClostridioides difficileEconomics, PharmaceuticalFemaleHumansMaleRecurrenceRetrospective StudiesTreatment OutcomeVancomycinAnti-Bacterial AgentsFidaxomicinVancomycinClostridioides difficile infectionDisease recurrenceFidaxomicinHealthcare resource utilizationObservational study

Identifiers

PMID41612217
PMCPMC12874842

What OpenQuestion holds

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Registered trials

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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.