Infection Risk and Safety of Corticosteroid Use

Corticosteroids are frequently used to treat rheumatic diseases . Their use comes with several 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 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 . In patients who begin chronic steroid therapy, vaccination and screening strategies should be used in an attempt to mitigate this risk.