Table 1.

Practice points for minimizing the risk of infectious complications during rituximab therapy

Practice points
1.	Consider patient-specific risk factors prior to treatment: Age Indication for rituximab use Comorbidities Prior exposure to and concomitant use of other immunosuppression
2.	Screen for HBV prior to treatment Prophylaxis for those with positive HBV serology (as per algorithm)
3.	Assess risk of TB reactivation and need for chemoprophylaxis: Previous TB disease or exposure to TB Interferon-gamma release assay, i.e. QuantiFERON Chest X-ray abnormalities
4.	If possible, vaccinate for bacterial and viral pathogens, including: Pneumococcus Influenza A and B Haemophilus influenza B Meningitis C HBV
5.	Prescribe prophylaxis for Pneumocystis jiroveci pneumonia
6.	Contraceptive advice for both men and women
7.	Monitor full blood count and immunoglobulins prior to and during treatment Consider intravenous immunoglobulins if evidence of hypogammaglobulinaemia (<400 mg/dL) complicating recurrent infections
8.	Remain vigilant for signs and symptoms suggestive of infection during treatment course