title: Preventing infective complications in inflammatory bowel disease.
abstract: Over the past decade there has been a dramatic change in the treatment of patients with Crohn's disease and ulcerative colitis, which comprise the inflammatory bowel diseases (IBD). This is due to the increasing use of immunosuppressives and in particular the biological agents, which are being used earlier in the course of disease, and for longer durations, as these therapies result in better clinical outcomes for patients. This, however, has the potential to increase the risk of opportunistic and serious infections in these patients, most of which are preventable. Much like the risk for potential malignancy resulting from the use of these therapies long-term, a balance needs to be struck between medication use to control the disease with minimization of the risk of an opportunistic infection. This outcome is achieved by the physician's tailored use of justified therapies, and the patients' education and actions to minimize infection risk. The purpose of this review is to explore the evidence and guidelines available to all physicians managing patients with IBD using immunomodulating agents and to aid in the prevention of opportunistic infections.
authors.affiliation: Justine Mill, Ian C Lawrance, Centre for inflammatory Bowel Diseases, Fremantle Hospital, Fremantle, WA 6059, Australia.
authors.forename: Justine
authors.initials: J
authors.lastname: Mill
authors.affiliation: Justine Mill, Ian C Lawrance, Centre for inflammatory Bowel Diseases, Fremantle Hospital, Fremantle, WA 6059, Australia.
authors.forename: Ian C
authors.initials: IC
authors.lastname: Lawrance
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001688:Biological Products / Q000009:adverse effects*; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D005765:Gastrointestinal Agents / Q000009:adverse effects*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D009894:Opportunistic Infections / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control* / Q000821:virology; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D014611:Vaccination
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D001688:Biological Products; D005765:Gastrointestinal Agents; D007166:Immunosuppressive Agents
keywords: Anti-tumor necrosis factor agents; Complications; Immunosuppression; Infection; Inflammatory bowel diseases
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