Personalized medicine

Personalized infectious disease approach in high risk patients. Panel A. The current state of practice: Reflexive medicine. Patients undergoing immunomodulating therapy are monitored for infectious complications. Once an invasive infection is identified, treatment is initiated, although significant delay occurs to essential, life-saving chemotherapy or transplantation with higher burden of morbidity and mortality. Panel B. Future approach using personalized medicine: Predictive medicine. The ability to measure immune reserve prior to immunomodulating treatment identifies patients with low reserve and at highest risk for infectious complications. More intensive surveillance and prophylactic strategies can be designed specifically for this pre-identified population. In addition, adjustments in immunosuppressive regimens can be factored, thus reducing the morbidity and mortality as patients undergo treatment for their underlying disease.