Verminderde afweer

• Due to medication use, comorbidities and/or age, an increasing number of patients have an impaired immunity to infection.
• Impaired immunity may lead to an increased risk of (opportunistic) infection, complications from infections, and difficulties in the diagnosis of infections.
• Guided by clinical parameters, a general practitioner can classify an impaired immunity as ‘clinically irrelevant’, ‘limitedly relevant’ or ‘potentially serious’.
• Tocilizumab impairs the production of CRP, which makes it unreliable as an infection parameter.
• In case of a suspected infection in patients with severe immunosuppression, it will often be necessary to consult a specialist as quickly as possible about further diagnostic procedures and the need for, type and administration route of antimicrobials.
• In patients with an impaired immunity, adaptation of the antibiotic policy and prophylactic measures, such as vaccination, may be indicated.
• Patients with (functional) asplenia should immediately start antibiotic treatment in case of fever, pending clinical evaluation by a physician.

Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article.