Evaluation and prevention of infections associated with eculizumab

Medication	Effect on immune system	Associated infections^*	Pre-treatment testing	Pre-treatment vaccinations	Medical prophylaxis
Eculizumab	Inhibits C5 and reduces the number of terminal complement components (C5b-9) that form the membrane attack complex, leading to impaired cytolysis of encapsulated bacteria	*Serious infections due to encapsulated bacteria (Neisseria meningitidis, S. pneumoniae, and Haemophilus influenzae* type b [Hib])**	No testing necessary	Routine age-appropriate vaccinations should be administered before beginning therapy (especially Hib) Administer initial or booster N. meningitidis vaccine at least 2 weeks prior to starting treatment Administer pneumococcal vaccine(s)	Antibacterial prophylaxis with penicillin or a macrolide can be considered in certain cases

This table serves as an overview of how to evaluate for and prevent infections in patients starting and/or taking eculizumab. Infections highlighted in bold have been specifically associated with the agent and warrant extra consideration.

Hib: Haemophilus influenzae type b.

* In addition to the infections listed, typical, common bacterial and viral infections should also be considered in the differential when infection is suspected in a patient taking the specified agent.

Graphic 143343 Version 1.0

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Evaluation and prevention of infections associated with eculizumab