How can we reduce the risk of serious infection for patients with systemic lupus erythematosus?

Infection is responsible for approximately 25% of all deaths in patients with systemic lupus erythematosus (SLE), making it a leading cause of mortality among patients. Ruiz-Irastorza and colleagues, in a recent issue of Arthritis Research & Therapy, report the clinical predictors of major infections found in a prospective study of patients with SLE. Similar patterns of infection and pathogens as reported in previous studies were seen; what is striking, however, was the protective effect seen with anti-malarial use. Many infections in patients with SLE could be prevented with timely vaccinations, reducing exposure to contagious contacts, screening for latent infections, minimizing exposure to corticosteroids, targeted prophylaxis for high risk patients, and, unless contraindicated, anti-malarial therapy as standard of care.