levoleucovorin and Respiratory-Tract-Infections

Morbidity and mortality from pneumonia is increased in patients with rheumatoid arthritis. Factors contributing to this have been recently identified and a number of recommendations have been implemented in an attempt to reverse this trend. The present paper shows that these measures have combined to produce a fourfold reduction in both admissions and case fatality rates. In the study population, immunisation rates against influenza and pneumococcus have improved to 86% and 65%, oral steroid consumption has halved and disease modifying drugs were usually appropriately suspended during acute infection. These measures may now merit more widespread adoption.

Topics: Aged; Antirheumatic Agents; Arthritis, Rheumatoid; Clinical Protocols; Female; Glucocorticoids; Granulocyte Colony-Stimulating Factor; Humans; Influenza Vaccines; Leucovorin; Leukocyte Count; Male; Middle Aged; Neutropenia; Patient Admission; Pneumococcal Vaccines; Prednisone; Respiratory Tract Infections; Risk Factors; United Kingdom; Vaccination; Vitamin B Complex