Value of anti-infective chemoprophylaxis in primary systemic vasculitis: what is the evidence? |
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Authors: | Frank Moosig Julia U Holle Wolfgang L Gross |
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Institution: | (1) Department of Rheumatology, University Hospital of Schleswig Holstein and Klinikum Bad Bramstedt, Oskar Alexander Str. 26, 24576 Bad Bramstedt, Germany |
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Abstract: | 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. |
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