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Arthritis Res Ther. 2009;11(5):253. doi: 10.1186/ar2826. Epub 2009 Oct 28.

Value of anti-infective chemoprophylaxis in primary systemic vasculitis: what is the evidence?

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  • 1Department of Rheumatology, University Hospital of Schleswig Holstein and Klinikum Bad Bramstedt, Oskar Alexander Str, 26, 24576 Bad Bramstedt, Germany.


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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