32
Management
Table 9B. Special Considerations for Antibiotic Treatment in
At-Risk Individuals
Special antimicrobial considerations
Neonates TMP/SMX can cause hyperbilirubinemia in neonates;
prophylaxis may be delayed until approximately 4 wk of age.
Pregnancy Many antimicrobials used in IEI bear increased risks including
but not limited to TMP/SMX, azoles, tetracyclines, and
fluoroquinolones and require risk/benefit discussions.
Photosensitivity Voriconazole and doxycycline and less frequently TMP/SMX
can cause photosensitivity, and long-term voriconazole has been
associated with skin cancers.
Electrocardiogram
(EKG) abnormalities
Several antimicrobials used in IEI can be associated with prolonged
QTc, such as azithromycin, fluoroquinolones, and certain azoles,
and thus underlies a need monitoring for this arrythmia.
Section 10. Management of Comorbidities in Inborn Errors
of Immunity
Recommendation 10.1
➤ We suggest that systemic comorbidities in patients with IEI should be
evaluated and managed with a multidisciplinary team with expertise
in IEI-related comorbidities. (C-S; L-M)
Recommendation 10.2
➤ We recommend prompt management of cytopenia(s) or malignancies
in patients with IEI. (S-M)
