IV Iron Therapy Linked to Improved Survival in Hospitalized Patients with Anemia and Bacterial Infections
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A new analysis of over 85,000 patients suggests that intravenous (IV) iron treatment is a safe and effective therapy for individuals hospitalized with both iron-deficiency anemia and acute bacterial infections.The research, set to be presented December 7, 2025, indicates a significant improvement in survival rates and hemoglobin levels among those receiving IV iron compared to untreated patients.
For years, the use of IV iron in patients battling both anemia and bacterial infections has been a point of contention within the medical community. Concerns stemmed from laboratory findings suggesting certain bacteria could thrive in the presence of added iron. Despite these theoretical risks, a growing body of evidence now challenges long-held treatment guidelines.
Landmark Study Analyzes Real-World Patient Data
The study, led by Haris sohail, MD, a fellow in hematology-oncology at Charleston Area Medical Center in West Virginia, utilized a large database of de-identified patient records from medical centers across the United States. Researchers focused on individuals aged 18 and over diagnosed with iron-deficiency anemia and hospitalized with an acute bacterial infection between 2000 and 2024.
The analysis encompassed data from patients with the most prevalent bacterial infections seen in U.S. hospitals: pneumonia (over 27,000 patients), urinary tract infections (over 23,000), methicillin-resistant Staphylococcus aureus (MRSA) infections (over 15,000), cellulitis (over 13,000), and colitis (over 7,000). A smaller cohort of 143 patients with bacterial meningitis was also included.
Significant Survival Benefits Observed across Multiple Infections
Researchers compared outcomes between patients who received IV iron treatment and those who did not, focusing on mortality rates at 14 and 90 days, hospital length of stay, and changes in hemoglobin levels. The results were compelling.
For all infections examined except bacterial meningitis,patients treated with IV iron demonstrated a statistically significant reduction in mortality within both 14 and 90 days,alongside substantial increases in hemoglobin levels. “Our data show that it is safe to give IV iron to patients who have both iron-deficiency anemia and an acute bacterial infection, and that, compared with untreated patients, those treated with IV iron have better overall survival and higher hemoglobin levels,” a lead researcher stated.
The most pronounced survival benefits were observed in patients battling pneumonia, bloodstream MRSA infections, and colitis. While IV iron recipients experienced a slightly longer hospital stay – approximately four to six hours – this difference was deemed clinically insignificant.
Meningitis Findings require Further Investigation
The study revealed no significant impact of IV iron on survival rates in patients with bacterial meningitis. Though, researchers emphasize that the treatment did not worsen outcomes for this patient group, and the limited sample size (143 patients) likely contributed to the lack of statistically significant findings.
Study Limitations and Future Research
Dr. Sohail acknowledged the study’s limitations, noting that the retrospective nature of the analysis establishes an association, but cannot definitively prove causation. Moreover, the database lacked detailed facts regarding specific bacterial strains and iron dosages administered. The findings are most applicable to hospitalized patients presenting with both iron-deficiency anemia and an active bacterial infection.
“Additional study limitations…are that the database the researchers used did not provide detailed information about specific bacteria or iron doses,” Dr. Sohail explained. He indicated that a randomized controlled trial is the next logical step to confirm these findings and solidify the role of IV iron in this patient population.
“Our findings support consideration of the use of IV iron as a safe additional therapy for patients who are hospitalized with both iron-deficiency anemia and an acute bacterial infection,” Dr. Sohail concluded. The research is scheduled to be presented at the American Society of Hematology’s annual meeting on Sunday, December 7, 2025, at 3:25 p.m. Eastern time in West Hall D2 of the Orange County Convention Center.
