Assessing the incidence of skin and soft tissue infection in patients on biologics.

Abstract:

BACKGROUND:Biologic agents may predispose patients to skin and soft tissue infections (SSTIs). Guidelines recommend discontinuing the agent pre-operatively; the true risk of infection is unclear. OBJECTIVES:To assess the incidence of SSTIs in patients on biologic agents for all clinical indications. A secondary aim is to assess those undergoing surgery to determine post-operative SSTI risk. METHODS:A retrospective medical record review was conducted at two urban tertiary care hospitals. Biologic agent usage ranged from June 2013-2018. Data was extracted on biologic agent injections, surgical procedures, and patient characteristics. RESULTS:Hypertension, former smoking, and corticosteroid use was significantly associated with SSTI risk (p<0.05). There was no increased SSTI risk among biologic agents (p=0.49). Biologic therapy with concomitant corticosteroid use increased risk of SSTI (p=0.0049). There was no difference in post-operative SSTI risk in patients who stopped biologic therapy pre-operatively and those who did not. LIMITATIONS:This study is limited by retrospective design. CONCLUSIONS:There was no increased risk of either post-operative or non-perioperative SSTI risk among biologic agents. Concomitant corticosteroid use increased SSTI risk. Current guidelines regarding stopping biologic agents pre-operatively warrant re-evaluation, as there was no difference in SSTI risk in patients who did so.

journal_name

J Am Acad Dermatol

authors

Nguyen ED,Gabel CK,Kroshinsky D

doi

10.1016/j.jaad.2020.03.128

subject

Has Abstract

pub_date

2020-05-05 00:00:00

eissn

0190-9622

issn

1097-6787

pii

S0190-9622(20)30794-5

pub_type

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