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Medication and infection or surgery

Infection and medication

We do not advise changing a patient's medication unless they are to be admitted to hospital. If you feel there is a circumstance in which this should not apply or if the patient is to be admitted with an infection, please contact us.


Unless the patient's inflammatory disease has flared or there are specific clinical indications for increasing the dose (eg cerebral oedema), the dose of prednisolone should not be decreased or increased during an infection.

Relative steroid resistance during an infection is not an indication for increasing the dose.

Long Term Immunosuppression

Medications including methotexate, azathioprine, cyclosporine, anti-TNF therapy (etanercept, adalimumab and infliximab) and anakinra do not need to be altered for regular coughs and colds or diarrhoea illnesses.

If the child is to be admitted for treatment, please stop the immunosuppression agent until you have discussed further management with us.

Surgery and medication

Elective Surgery

In general there is no indication to withhold medication (other than biologic agents) prior to clean elective surgery.

For elective surgery involving the gut or specifically areas of infection please contact us.

If the patient is receiving etanercept, adalimumab, anakinra or other biologic agent we advise omitting the drug for 1 week prior to and 1 week after clean elective surgery, unless there is to be insertion of a prosthesis.

If a prosthesis is considered or the surgery involves the gut or infection please contact us.

Emergency Surgery

In general we advise omitting medication for up to 10-14 days after emergency surgery, but please contact us for further advice. In some patients undergoing a clean procedure this may not be necessary.