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Author Notes:

Correspondence: DScott1@cdc.gov

RS, RS, JB, SC, and JJ were involved in the conception and design.

RS, RS, and FL were involved in data collection.

RS, RS, FL, JB, CM and were involved in data interpretation.

RS, JB, SC, CM and JJ were involved in writing the manuscript.

All authors read and approved the final manuscript.

The authors would like to thank Ashley Rose for reviewing the manuscript.

The authors declare that they have no competing interests.


Research Funding:

Not applicable.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Public, Environmental & Occupational Health
  • Infectious Diseases
  • Microbiology
  • Healthcare-associated infections
  • Clostridioides difficile infection
  • Antibiotic stewardship
  • Regulatory impact analysis
  • Value of statistical life
  • Cost-benefit analysis
  • LIFE

Assessing the social cost and benefits of a national requirement establishing antibiotic stewardship programs to prevent Clostridioides difficile infection in US hospitals


Journal Title:

Antimicrobial Resistance and Infection Control


Volume 8


, Pages 17-17

Type of Work:

Article | Final Publisher PDF


Backgound: Economic evaluations of interventions to prevent healthcare-associated infections in the United States rarely take the societal perspective and thus ignore the potential benefits of morbidity and mortality risk reductions. Using new Department of Health and Human Services guidelines for regulatory impact analysis, we developed a cost-benefit analyses of a national multifaceted, in-hospital Clostridioides difficile infection prevention program (including staffing an antibiotic stewardship program) that incorporated value of statistical life estimates to obtain economic values associated with morbidity and mortality risk reductions. Methods: We used a net present value model to assess costs and benefits associated with antibiotic stewardship programs. Model inputs included treatment costs, intervention costs, healthcare-associated Clostridioides difficile infection cases, attributable deaths, and the value of statistical life which was used to estimate the economic value of morbidity and mortality risk reductions. Results: From 2015 to 2020, total net benefits of the intervention to the healthcare system range from $300 million to $7.6 billion when values for morbidity and mortality risk reductions are ignored. Including these values, the net social benefits of the intervention range from $21 billion to $624 billion with the annualized net benefit of $25.5 billion under our most likely outcome scenario. Conclusions: Incorporating the economic value of morbidity and mortality risk reductions in economic evaluations of healthcare-associated infections will significantly increase the benefits resulting from prevention.

Copyright information:

© The Author(s). 2019

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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