The percentage of clostridium difficile infections (CDI) that develop at least one recurrence is much lower in Japan than in other markets.

According to GlobalData’s recently published CDI EpiCast report, 9.3% of CDI cases in Japan in 2016 developed at least one recurrence within 60 days of the initial infection. In other markets, this percentage ranged from 16% to 18.2%.

Figure 1 displays the recurrence rate in the seven major markets (7MM) of the US, France, Germany, Italy, Spain, the UK, and Japan in 2016.

CDI is primarily transmitted through the fecal-oral route and is often associated with overnight visits to healthcare facilities. The primary risk factors for the disease include previous antibiotic use, recent hospitalisation, and increased age.

CDI most often causes watery diarrhea, anorexia, and nausea, while severe cases can result in ileus and toxic megacolon.

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Uncomplicated CDI patients typically experience a full recovery after treatment with appropriate antibiotics, such as metronidazole or vancomycin. However, patients may experience a recurrence of symptoms within two months. This may be the result of a relapse of the initial infection or a re-infection of a patient who was exposed to the agent while still susceptible. Literature indicates that continued treatment with antibiotics and a decreased immune response to C. difficile toxins increase the likelihood of CDI recurrence.

While the recurrence rate in Japan is much lower than other countries, the incidence rate is not substantially different from the five major European markets (5EU) of France, Germany, Italy, Spain, and the UK. The reasons for greater prevention of CDI recurrences in Japan could include improved antibiotic stewardship and infection control among CDI patients.

Control of CDI recurrences in Japan can serve as a gold standard for other countries, especially the US, where the number of CDI cases is high and growing.

Details about the trend analysis and other discussions of CDI epidemiology can be found in GlobalData’s EpiCast reports: 'Clostridium difficile Infection (CDI) – Epidemiology Forecast to 2026' and 'EpiCast Model: Clostridium difficile Infection (CDI) – Epidemiology Forecast to 2026'.

Related reports

EpiCast Report: Clostridium difficile Infection (CDI) – Epidemiology Forecast to 2026. 2017.

EpiCast Model: Clostridium difficile Infection (CDI) – Epidemiology Forecast to 2026. 2017.