Frequency of sepsis after local corticosteroid injection (an inquiry on 1 160 000 injections in rheumatological private practice in France)

Objectives. The principal aims of this study were to determine the frequenc y of sepsis after local corticosteroid injection (SALCSI), to compare the r esults with those of the literature and to determine the main factors leadi ng to a decrease in the frequency of SALCSI. Methods. A retrospective study was conducted among 69 rheumatologists in pr ivate practice. Sixteen items were studied and are reported. Results. The mean number of years of private practice in rheumatology was 2 0.9. The total number of CS injections (CSI) was 1 160 000 for an average o f 809 CSI per year and per therapist. The mean number of CST performed by o ne rheumatologist was 16 800. Fifteen SALCSI had occurred, which correspond s to a frequency of 1/77 300 CSI. The rate of SALCSI for the older rheumato logists was lower than that of their younger colleagues. The frequency of u se of corticosteroid packaged in a sterile syringe (CSPSS)was similar to 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 fre quency of SALCSI was 1/162 000 after the use of CSPSS and 1/21 000 after th e use of CS not packaged in a sterile syringe. Conclusions. The mean frequency of SALCSI in Paris and the surrounding area was 1/77 300 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 rh eumatologist, but even more to the use of CSPSS.