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splenectomy

the patient who has had a splenectomy

see also:

introduction

  • patients who have had a splenectomy are at high risk of sepsis / septicaemia, in particular, due to pneumococcus
  • in addition, risk applies to those patients with “functional asplenia” such as those with sickle cell disease (SCD)
  • risk is highest in children and the immunocompromised, and the risk remains lifelong.

vaccination prophylaxis

  • standard schedule immunisation
  • pneumococcal vaccination
  • meningococcal vaccination
  • annual influenza vaccination

antibiotic prophylaxis for postsplenectomy and hyposplenic patients

  • asplenic children < 5 years of age
  • children < 5 years of age with sickle cell disease (SCD)
  • for at least 3 years following splenectomy
  • asplenic patients with severe underlying immunosuppression
  • for at least 6 months after an episode of severe sepsis in asplenic patients

prophylaxis

  • amoxycillin 250mg (20 mg/kg for those under age 2yrs) once daily
  • if penicillin allergy, then consider roxithromycin 150mg (4mg/kg in children to max 150mg), once daily
splenectomy.txt · Last modified: 2014/01/13 05:58 by 127.0.0.1

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