DMARD’S

Information on the use of antibiotics and vaccines in patients taking Disease Modifying Anti-rheumatic Drugs (DMARDS).

Vaccines

Patients with Rheumatoid arthritis, psoriatic arthritis, other inflammatory arthritides, vasculitis & lupus and other immune-mediated inflammatory disorders are at increased risk of some infectious disease that can be prevented by vaccines. Inactive vaccines are considered safe – including influenza, pneumococcal & hepatitis B.

Live vaccines are contra-indicated.

If at all possible, vaccination status should be updated before commencing disease-modifying therapy. In practice, this can prove difficult as live vaccines must be given 4 weeks before start of therapy and these inflammatory disorders usually require prompt treatment to ensure disease control.

Infection

to be added here