title: Infection Risk and Safety of Corticosteroid Use.
abstract: Corticosteroids are frequently used to treat rheumatic diseases. Their use comes with several well-established risks, including osteoporosis, avascular necrosis, glaucoma, and diabetes. The risk of infection is of utmost concern and is well documented, although randomized controlled trials of short-term and lower-dose steroids have generally shown little or no increased risk. Observational studies from the real world, however, have consistently shown dose-dependent increases in risk for serious infections as well as certain opportunistic infections. In patients who begin chronic steroid therapy, vaccination and screening strategies should be used in an attempt to mitigate this risk.
authors.affiliation: Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA. Electronic address: youssefj@ohsu.edu.
authors.forename: Jameel
authors.initials: J
authors.lastname: Youssef
authors.affiliation: Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA.
authors.forename: Shannon A
authors.initials: SA
authors.lastname: Novosad
authors.affiliation: Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97239, USA.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Winthrop
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D001424:Bacterial Infections; D005938:Glucocorticoids / Q000009:adverse effects*; D006562:Herpes Zoster / Q000139:chemically induced* / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D016867:Immunocompromised Host; D008403:Mass Screening; D009894:Opportunistic Infections / Q000139:chemically induced* / Q000276:immunology / Q000517:prevention & control; D011020:Pneumonia, Pneumocystis / Q000139:chemically induced* / Q000276:immunology / Q000517:prevention & control; D012216:Rheumatic Diseases / Q000188:drug therapy*; D014376:Tuberculosis / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology / Q000517:prevention & control; D014612:Vaccines / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D005938:Glucocorticoids; D014612:Vaccines
keywords: Bacterial infections; Corticosteroids; Opportunistic infections; Rheumatic diseases