Value of anti-infective chemoprophylaxis in primary systemic vasculitis: what is the evidence?
Although infections are a major concern in patients with primary systemic vasculitis, actual knowledge about risk factors and evidence concerning the use of anti-infective prophylaxis from clinical trials are scarce. The use of high dose glucocorticoids and cyclophosphamide pose a definite risk for infections. Bacterial infections are among the most frequent causes of death, with Staphylococcus aureus being the most common isolate. Concerning viral infections, cytomegalovirus and varicella-zoster virus reactivation represent the most frequent complications. The only prophylactic measure that is widely accepted is trimethoprim/sulfamethoxazole to avoid Pneumocystis jiroveci pneumonia in small vessel vasculitis patients with generalised disease receiving therapy for induction of remission.
Moosig
Frank
F
Department of Rheumatology, University Hospital of Schleswig Holstein and Klinikum Bad Bramstedt, Oskar Alexander Str, 26, 24576 Bad Bramstedt, Germany. moosig@klinikumbb.de
Holle
Julia U
JU
Gross
Wolfgang L
WL
D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000150:complications / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D006801:Humans; D056647:Systemic Vasculitis / Q000150:complications* / Q000276:immunology; D014777:Virus Diseases / Q000150:complications / Q000517:prevention & control*
D000890:Anti-Infective Agents