Infection Risk and Safety of Corticosteroid Use.
Infection Risk and Safety of Corticosteroid Use.
复制标题
DOI：
10.1016/j.rdc.2015.08.004
复制
发表时间：
2016-02
期刊：
影响因子：
--
通讯作者：
Winthrop KL
中科院分区：
文献类型：
--
作者：
Youssef J;Novosad SA;Winthrop KL
皮质类固醇常用于治疗风湿性疾病。它们的使用伴随着一些公认的风险，包括骨质疏松症、缺血性坏死、青光眼和糖尿病。尽管短期和低剂量类固醇的随机对照试验（rct）通常显示很少或没有增加风险，但感染的风险是最令人担忧的，并且有充分的证据证明。然而，来自“真实世界”的观察性研究一致显示，严重感染以及某些机会性感染（如带状疱疹、结核病和PJP）的风险呈剂量依赖性增加。在开始慢性类固醇治疗的患者中，应利用疫苗接种和筛查策略来减轻这种风险。
Corticosteroids are frequently used to treat rheumatic diseases. Their use comes with a number of 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 (RCTs) 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 (e.g. herpes zoster, tuberculosis, and PJP). In patients who begin chronic steroid therapy, vaccination and screening strategies should be utilized in an attempt to mitigate this risk.