What is your approach to iron supplementation in patients with an active infection?
In patients with active infections, I generally avoid intravenous iron due to the potential for promoting pathogen growth, a practice supported by cautions from nephrology and gastroenterology society guidelines. However, evidence for the risk of infection with IV iron is inconsistent, underpowered,...
A recent retrospective study in Blood showed no adverse outcomes between those hospitalized with infections who received IV iron vs those who did not. If anything, the study showed a trend towards improved survival in those who received IV iron.
It was an anecdotal concern that pathogens may benefit from high iron environments.
A new retrospective study posted on Jan 2026 tracked over 85,000 patients hospitalized with an infection who received IV iron during hospitalization. It enhanced the recovery of anemia and supports the safety of use o...