OBJECTIVES: To assess the impact of maintenance versus episodic infliximab therapy on hospitalizations and surgery in patients with Crohn's disease (CD). METHODS: A retrospective analysis of claims data was conducted from the Marketscan Commercial Claims and Encounters database from 2000 to 2003 for claimants with CD (ICD-9 codes, 555.0, 555.1, 555.2 or 555.9) who had an induction regimen (3 infusions) of infliximab in 2003. Continuous enrollment for 12 months pre- and 12 months post- the index infusion date in 2003 was required. Patients were excluded if they had infliximab infusions in 2001 or 2002. Cohort analyses were conducted for three distinct cohorts: 1) 1-2 infliximab infusions; 2) 3-4 infliximab infusions; 3) 5 or more infliximab infusions. RESULTS: Analyses were conducted on 126 patients who met the inclusion criteria. The majority of patients were female (53.2%) and the mean age was 49.5 years. Among the cohort with 5 or more infliximab infusions (n=34), 20.6% required hospitalization, as compared to 37.5% of the cohort with 1-2 infusions (n=48) and 34.1% of the cohort with 3-4 infusions (n=44). The cohort with 5 or more infliximab infusions also had fewer mean hospitalizations (1.29 vs. 1.83 and 1.47, ns), and shorter lengths of stay (5.11 days vs. 5.64 days and 5.91 days; ns). In addition, the percentage of patients requiring surgery was decreased for the 5 or more infusion cohort (24%) as compared with the other cohorts (40% each). CONCLUSION: Although not-significant, the results of this analysis indicate that when treating CD with a maintenance schedule of infliximab, the number and length of hospitalizations are reduced, and the percentage of patients requiring surgery decreases. Infliximab should be used on a maintenance schedule rather than episodically (i.e.: treatment of flares) in order to optimize treatment outcomes.