Page 199 - HPP ANTIMICROBIAL GUIDELINE 2018
P. 199
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
