Management of Infections in Rheumatic Diseases

There is a higher frequency of infections in rheumatologic patients compared to the general population, mainly respiratory, skin, soft tissue, and urinary tract infections. The etiologic agents are usually the same as those of community-acquired infections in the general population, although with a higher prevalence of opportunistic infections; therefore, the same antimicrobials recommended for the general population are used. The individual assessment of the infections risk in patients with rheumatic diseases is based on detailed personalized documentation of relevant risk factors, such as the underlying disease itself, the intensity of immunosuppressive therapy, and the severity of any comorbidity. The history of repeated and severe infections as well as previous illnesses, such as (latent) tuberculosis and chronic hepatitis B, and in some cases, prophylactic therapy might be required. Furthermore, vaccines are particularly suited to specifically minimizing the risk of frequent infectious diseases.