Frequency of sepsis after local corticosteroid injection (an inquiry on 1160000 injections in rheumatological private practice in France).

Abstract

The principal aims of this study were to determine the frequency of sepsis after local corticosteroid injection (SALCSI), to compare the results with those of the literature and to determine the main factors leading to a decrease in the frequency of SALCSI. A retrospective study was conducted among 69 rheumatologists in private practice. Sixteen items were studied and are reported. The mean number of years of private practice in rheumatology was 20.9. The total number of CS injections (CSI) was 1160000 for an average of 809 CSI per year and per therapist. The mean number of CSI performed by one rheumatologist was 16 800. Fifteen SALCSI had occurred, which corresponds to a frequency of 1/77300 CSI. The rate of SALCSI for the older rheumatologists was lower than that of their younger colleagues. The frequency of use of corticosteroid packaged in a sterile syringe (CSPSS) was approximately 85%. Nine out of the 15 cases of sepsis had occurred after the use of CS not packaged in a sterile syringe and six after the use of CSPSS. Thus, the frequency of SALCSI was 1/162000 after the use of CSPSS and 1/21000 after the use of CS not packaged in a sterile syringe. The mean frequency of SALCSI in Paris and the surrounding area was 1/77300 during the last 21 yr, a decrease since the 1960s and 1970s. This decreased incidence is in part due to the greater experience of the rheumatologist, but even more to the use of CSPSS.