[Antibiotic prophylaxis against bacterial infections in the hyposplenic and asplenic child].

Abstract

RISK OF INFECTION IN SPLENECTOMIZED CHILDREN: Observations in cohorts of splenectomized patients have led to the conclusion that the risk of bacterial infection is highest among young children, particularly under the age of 2 years, within 2 years of splenectomy and in children with an associated disease.

SEVERITY OF THE INFECTIONS:

According to the Holdsworth study conducted between 1952 and 1987, the rate of postoperative infection in splenectomized children under the age of 16 years is 4.4%, mortality reaching 2.2%. The risk of severe bacterial infection is also high in sickle-cell anemia children and is the leading cause of death in this age group.

BASIS FOR ANTIBIOTIC PROPHYLAXIS:

Current guidelines concerning antibiotic prophylaxis in asplenic and hyposplenic children are based on several notions: not giving antibiotic prophylaxis is unacceptable due to the major vulnerability of these children to pneumococcal infection and the frequence of pneumococcal colonization in this age group; the antibiotic given should have a narrow spectrum.

GUIDELINES:

Antibiotic prophylaxis against infection in asplenic and hyposplenic children is based on daily administration of Oracilline (Penicilline V). Prophylaxis is started at diagnosis in sickle-cell anemia children, i.e. around 2-3 months of age in case of neonatal screening. Oracilline should be given at least 5 years after splenectomy or even longer, and up to the age of 15 years in sickle-cell anemia children who develop frequent ENT/bronchial complications or have a history of pneumococcal infection.

• Authors: M de Montalembert
• Journal: Presse medicale (Paris, France : 1983) (Presse Med) Vol. 32 Issue 28 Suppl Pg. S15-6 (Sep 06 2003) ISSN: 0755-4982 [Print] France
• Vernacular Title: Antibioprophylaxie des infections bactériennes chez l'enfant hyposplénique ou asplénique.
• PMID: 14631640 (Publication Type: Comparative Study, English Abstract, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Penicillin V

Topics

• Adolescent
• Age Factors
• Anemia, Sickle Cell (complications, drug therapy)
• Anti-Bacterial Agents (administration & dosage, therapeutic use)
• Antibiotic Prophylaxis
• Bacterial Infections (etiology, prevention & control)
• Child
• Child, Preschool
• Humans
• Infant, Newborn
• Penicillin V (administration & dosage, therapeutic use)
• Practice Guidelines as Topic
• Risk Factors
• Splenectomy (adverse effects)
• Time Factors