Guidelines for the management of patients with an absent or poorly functioning spleen: Prophylactic antibiotics.

• Susceptibility to infection may be greatest in the first few years following the splenectomy, but persists for life.
• Compliance with lifelong antibiotics can be a problem.

Recommendation:

• All adults should receive antibiotic prophylaxis for at least 2 years following splenectomy and lifelong antibiotics should be considered for patients with lymphoproliferative disease.
  • Penicillin V 500mg bd
  • If penicillin allergic, Clarithromycin PO 250mg bd
  • If NBM following surgery give, Benzylpencillin IV1.2g bd UNLESS allergy or already receiving other antibiotics with appropriate activity. (Discuss with microbiology if unsure.)
• Children should receive appropriate antibiotic cover until 16 years of age  (and for a minimum of 2 years- see full guidance).
• If compliance is a problem, or following the 2 year prophylactic course, the patient may be given a single dose of Amoxicillin 500mg or Clarithromycin 500mg for use at the first sign of infection whilst seeking medical advice.

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Click here for the full Guideline " Management of patients with an absent or dysfunctional spleen"

Page last edited: 20/05/2009

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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