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What Nephrologists Should Know About Infection Prevention Measures Before and During Eculizumab Administration in

Shirin Sayyahfar1

  • 1Research Center of Pediatric Infectious Diseases, Institute of Immunology and Infectious Diseases, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Iranian Journal of Kidney Diseases
|June 3, 2026
PubMed

Insights

Children on eculizumab (a terminal complement inhibitor) face high infection risks, especially from meningococcal disease. Vaccination and antibiotic prophylaxis are crucial for preventing serious infections in these pediatric patients.

Area of Science:

  • Immunology
  • Pharmacology
  • Pediatrics

Background:

  • Eculizumab is a monoclonal antibody inhibiting the terminal complement pathway (C5b-9).
  • It's used in Iran for various adult and pediatric conditions.
  • Patients on eculizumab have increased risk of life-threatening infections, notably meningococcal disease.

Purpose of the Study:

  • To address pediatric nephrologists' questions on vaccination changes for children receiving eculizumab.
  • To discuss increased infection risks and emphasize preventive measures.
  • To provide updated recommendations for infection prevention during eculizumab treatment.

Main Methods:

  • Review of current literature and clinical guidelines.
  • Focus on infection prevention strategies for pediatric patients.
  • Analysis of eculizumab's mechanism and associated risks.

Main Results:

  • Children on eculizumab require specific vaccination, including the meningococcal vaccine.
  • Combined vaccination and prophylactic antibiotic use is the most effective prevention strategy.
  • Antibiotic prophylaxis should commence with eculizumab and continue post-treatment.

Conclusions:

  • Routine vaccination schedules may need modification for children on eculizumab.
  • Proactive infection prevention, including vaccination and antibiotics, is essential.
  • Adherence to updated guidelines ensures optimal patient safety during eculizumab therapy.

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