Page 198 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 198

Post splenectomy

               Duration
               Preferably life long, or at least
               • Children up to the age of 16 years
               • A minimum of 2 years
               • Indefinitely for patients with an underlying immunodeficiency or immunocompromised state and asplenia

               Important adjunct:
               Immunization against Pneumococcus, Haemophilus, Meningococcus at least 14 days prior to splenectomy.
               (If not possible then 14 days postoperative day)

               Yearly influenza vaccine also recommended.
               (Please refer relevant immunization guidelines for schedule)

               To seek immediate medical attention when febrile or to instruct on immediate self-directed empiric antibiotics (amoxicillin/clavulanate or cefuroxime axetil)
               before promptly seeking medical care.



                                                            Suggested Treatment
                   Infection/Condition                                                                                    Comments
                                                   Preferred                   Alternative

                 Post splenectomy         Penicillin V PO             Amoxicillin (20mg/kg/day)
                 At risk for Pneumococcus,  125mg q12h for ≤ 2yo
                 Meningococcus,           250mg q12h for > 2yo        Penicillin Allergy :
                 Haemophilus                                          Erythromycin ethylsuccinate
                                                                      200mg PO daily < 2 yo
                                                                      400mg daily > 2 yo











               HPP AMG                                                       Chemoprophylaxis                                                            94
   193   194   195   196   197   198   199   200   201   202   203