Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3204411 | The Journal of Allergy and Clinical Immunology: In Practice | 2013 | 10 Pages |
Abstract
Long-term prophylactic antibiotics are being widely implemented as primary or adjunctive therapy in primary immune deficiencies. This practice has transformed clinical outcomes in the setting of chronic granulomatous disease, complement deficiencies, Mendelian susceptibility to mycobacterial disease, Wiskott-Aldrich syndrome, hyper-IgE syndrome, Toll signaling defects, and prevented Pneumocystis in patients with T-cell deficiencies. Yet, controlled trials are few in the context of primary antibody deficiency syndromes, and most of this practice has been extrapolated from data in patients who are immune competent and with recurrent acute otitis media, chronic rhinosinusitis, cystic fibrosis, and bronchiectasis. The paucity of guidelines on the subject is reflected in recent surveys among practicing immunologists that highlight differences of habit regarding this treatment. Such discrepancies reinforce the lack of standard protocols on the subject. This review will provide evidence for the use of antibiotic prophylaxis in various primary immune deficiency populations, especially highlighting the role antibiotic prophylaxis in primary antibody deficiency syndromes. We also discussed the relationship of long-term antibiotic use and the prevalence of resistant pathogens. Overall, examination of available data on the use of prophylactic antibiotics in antibody deficiency syndromes merit future investigation in well-designed multicenter prospective trials because this population has few other management options.
Keywords
Warts, hypogammaglobulinemia, infections, and myelokathexisBy mouthAAAAIX-linked hyper-IgM syndromePJPXLACVIDWHIMESIDRCTCGDSCIDTHIDPBMYD88HSVPIDNEMOAOMCRSBATPneumocystis jirovecii pneumoniaRandomized controlled trialAntibiotic prophylaxisAmerican Academy of Allergy, Asthma, and ImmunologyEuropean Society for ImmunodeficienciesX-linked agammaglobulinemiachronic granulomatous diseaseacute otitis mediaChronic rhinosinusitissulfamethoxazole-trimethoprimIRAK-4Cystic fibrosisCVID, common variable immunodeficiencyTransient hypogammaglobulinemia of infancyherpes simplex virusdiffuse panbronchiolitisPADmyeloid differentiation primary response gene (88)ImmunodeficiencySevere combined immune deficiency
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Authors
Merin MD, Maria Teresa MD,