Biologic therapy does not heighten risk of skin, soft tissue infections

Biologic agents do not appear to increase the risk of skin and soft tissue infections (SSTIs), a study has found. Meanwhile, concomitant use of corticosteroids heightens such risk.

Treatment with biologic agents has been thought to predispose patients to SSTIs, which is why current guidelines recommend discontinuing the agent preoperatively.

To clarify whether true risk of infection exists, researchers conducted a retrospective medical record review at two urban tertiary care hospitals. They evaluated the incidence of SSTIs in patients receiving biologic agents for all clinical indications and examined those undergoing surgery to determine postoperative SSTI risk.

Use of biologic agents ranged from June 2013 to June 2018. Data on biologic agent injections, surgical procedures, and patient characteristics were included.

Hypertension, former smoking, and corticosteroid use were all predictive of SSTI development (p<0.05). On the other hand, no significant association was found between biologic agents and increased SSTI risk (p=0.49), but biologic therapy with concomitant corticosteroid use showed a correlation (p=0.0049).

In addition, no difference was observed in postoperative SSTI risk in patients who discontinued use of biologic agents prior to surgery and those who did not.

“Current guidelines regarding stopping biologic agents before surgery warrant re-evaluation because there was no difference in SSTI risk in patients who did so,” researchers said.

The retrospective design of this study is a limitation, they added.