Parenteral iron-Does it increase infection risk?

Area of Science:

• Hematology
• Pharmacology
• Infectious Disease

Background:

• Iron deficiency (ID) and iron deficiency anaemia (IDA) are common, affecting diverse patient groups.
• Patient blood management (PBM) increasingly utilizes intravenous (IV) iron, raising questions about infection risk.
• This review examines the link between parenteral iron therapy and infection risk.

Purpose of the Study:

• To critically evaluate the relationship between parenteral iron therapy and infection risk.
• To assess various IV iron formulations, their benefits, safety, and infection-related complications.
• To analyze the impact of IV iron on infection risk across different clinical settings.

Main Methods:

• A comprehensive literature search was performed in PubMed, EMBASE, Medline, and CINAHL (2014-2024).
• Relevant observational studies and clinical trials investigating IV iron formulations and infection risk were analyzed.

Main Results:

• IV iron therapy effectively raises hemoglobin and reduces transfusion needs.
• Evidence suggests IV iron does not significantly elevate infection risk in cardiovascular, renal, antenatal, or surgical patients.
• Older formulations and high-dose IV iron may increase susceptibility due to non-transferrin-bound iron; newer formulations show a better safety profile.

Conclusions:

• IV iron is crucial for ID management, but patient-specific factors influencing infection risk require consideration.
• Further research is necessary to differentiate infection risks among IV iron types and patient groups.
• Personalized IV iron administration can maximize benefits and minimize adverse events.