Things We Do for No Reason™: Routinely withholding IV iron in hospitalized patients with infection

Withholding intravenous (IV) iron to treat iron-deficiency anemia (IDA) is a common practice in patients hospitalized with acute bacterial infection, driven by the theoretical risk from in vitro studies that iron may support bacterial growth. However, IV iron administration is beneficial for multiple patient populations with IDA, such as heart failure with reduced ejection fraction, chronic kidney disease, inflammatory bowel disease, and malignancy. Additionally, recent data suggest that administering IV iron in patients with infections does not worsen clinical outcomes. Routine withholding of IV iron in patients with adequately controlled infections should be avoided.