NASPGHAN Clinical Report: Surveillance, Diagnosis, and Prevention of Infectious Diseases in Pediatric Patients with Inflammatory Bowel Disease Receiving Tumor Necrosis Factor-Alpha Inhibitors
: Supplemental Digital Content is available in the text ABSTRACT: Children and adolescents with inflammatory bowel disease (IBD) receiving therapy with tumor necrosis factor alpha inhibitors (anti-TNFa) pose a unique challenge to healthcare providers in regards to associated risk of infection. Published experience in adult populations with distinct auto-inflammatory and autoimmune diseases who are being treated with anti-TNFa therapies indicate an increased risk of serious infections with intracellular bacteria, mycobacteria, fungi, and some viruses; there is a paucity of robust pediatric data. With a rising incidence of pediatric IBD and increasing use of biological therapies, heightened knowledge and awareness of infections in this population is important for primary care pediatricians, pediatric gastroenterologists, and infectious disease physicians.This clinical report is the result of a consensus review performed by pediatric infectious disease and gastroenterology physicians detailing relevant published literature regarding infections in pediatric patients with IBD receiving anti-TNFa therapies. The objective of this document is to provide comprehensive information for prevention, surveillance, and diagnosis of infections based on current knowledge, until additional pediatric data are available to inform evidence-based recommendations.