tailieunhanh - Báo cáo y học: "Value of anti-infective chemoprophylaxis in primary systemic vasculitis: what is the evidence"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Value of anti-infective chemoprophylaxis in primary systemic vasculitis: what is the evidence? | Available online http content 11 5 253 Review Value of anti-infective chemoprophylaxis in primary systemic vasculitis what is the evidence Frank Moosig Julia U Holle and Wolfgang L Gross Department of Rheumatology University Hospital of Schleswig Holstein and Klinikum Bad Bramstedt Oskar Alexander Str. 26 24576 Bad Bramstedt Germany Corresponding author Frank Moosig moosig@ Published 28 October 2009 This article is online at http content 11 5 253 2009 BioMed Central Ltd Arthritis Research Therapy 2009 11 253 doi ar2826 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. Introduction In patients with small vessel vasculitis SVV infectious complications are at least as often the cause of death as uncontrolled disease activity. For example in the recently published MEPEX-trial about 25 of the patients did not survive the first year and most of the deaths were attributable to overwhelming infectious complications 1 . Despite the fact that infections substantially contribute to morbidity and mortality in patients with primary systemic vasculitis PSV data on risk factors and on the burden of specific infectious agents are scarce. In oncology recommendations for .