Tresoldi AS, Sumilo D, Perrins M, et al. - Utilizing UK data obtained from 1995 to 2018, researchers conducted this retrospective cohort study to determine infection risk in primary adrenal insufficiency (PAI) due to Addison disease (AD) and congenital adrenal hyperplasia (CAH) in a primary care setting. In 1,580 AD patients (mean age 51.7 years) and 602 CAH patients (mean age 35.4 years), a diagnosis of PAI was established. According to findings, the risk of lower respiratory tract infections, urinary tract infections, and gastrointestinal infections was significantly increased in AD and CAH patients exposed to glucocorticoids but not in CAH patients without glucocorticoid treatment. This has been mirrored by increased antibiotic and antifungal prescriptions. In the primary care setting at least partially linked to glucocorticoid treatment, there is an increased risk of infections and antimicrobial use in PAI. Future investigations will need to discuss whether more physiological glucocorticoid replacement modes could lessen this risk.