title: [TNF-blocking drugs and infection; recommendations for daily practice].
abstract: Anti-tumour necrosis factor (TNF) therapy is associated with an increased risk of infection. There are sparse data and no evidence-based guidelines on how to deal with this problem in daily practice. However, recommendations can be made based on theoretical considerations and by extrapolating from recommendations for other types ofimmunodeficiency. Before starting anti-TNF therapy, screening for tuberculosis and other possible infections is indicated. During therapy, alertness is required to the increased risk of infection, infections with a more serious clinical course or unusual manifestations and opportunistic infections. Flu vaccination during anti-TNF therapy is indicated. Travel vaccinations with live microbial inocula should not be given.
authors.affiliation: Universitair Medisch Centrum Utrecht, afd. Reumatologie en Klinische Immunologie, Huispost Fo2.127, Postbus 85.500, 358 GA Utrecht. j.w.g.jacobs@umcutrecht.nl
authors.forename: J W G
authors.initials: JW
authors.lastname: Jacobs
authors.forename: M C W
authors.initials: MC
authors.lastname: Creemers
authors.forename: M A
authors.initials: MA
authors.lastname: van Agtmael
authors.forename: M A F J
authors.initials: MA
authors.lastname: van de Laar
authors.forename: T
authors.initials: T
authors.lastname: van der Poll
authors.forename: P P
authors.initials: PP
authors.lastname: Tak
authors.forename: J W J
authors.initials: JW
authors.lastname: Bijlsma
mesh_terms: D006801:Humans; D009894:Opportunistic Infections / Q000453:epidemiology* / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D000079424:Tumor Necrosis Factor Inhibitors
chemical_list: D000079424:Tumor Necrosis Factor Inhibitors