Prevention of opportunistic infections in immunosuppressed patients in the tropical top end of the Northern Territory.
The population of the Top End of the Northern Territory has a high incidence of several infections of particular significance in the immunosuppressed. The following protocol for evaluation and treatment of patients prior to immunosuppression was developed in order to reduce the incidence of serious opportunistic infections. The infections discussed are Strongyloides stercoralis, tuberculosis, scabies, chronic hepatitis B, melioidosis and other bacterial infections. We recommend that all patients planned to receive more than 0.5 mg/kg/day of prednisolone for >14 days, or any more potent immunosuppressive drug, be evaluated and treated according to this protocol. Details of the rationale, evidence base, and proposed investigations and therapy for such patients are discussed.
Davis
Joshua S
JS
Division of Medicine, Royal Darwin Hospital, Rocklands Drive, Tiwi, Northern Territory.
Currie
Bart J
BJ
Fisher
Dale A
DA
Huffam
Sarah E
SE
Anstey
Nicholas M
NM
Price
Richard N
RN
Krause
Vicki L
VL
Zweck
Nathan
N
Lawton
Paul D
PD
Snelling
Paul L
PL
Selva-Nayagam
Sid
S
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006509:Hepatitis B / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D015876:Northern Territory / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D012532:Scabies / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D013322:Strongyloidiasis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D014329:Tropical Climate; D014376:Tuberculosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control