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Title: Prophylaxis against postsplenectomy pneumococcal infection.
Austin Authors: Siddins, M;Downie, J;Wise, K;O'Reilly, M
Affiliation: Department of Surgery, Austin Hospital, Heidelberg, Victoria, Australia
Issue Date: 1-Mar-1990
Publication information: Australian and New Zealand Journal of Surgery; 60(3): 183-7
Abstract: An excess risk of overwhelming sepsis following splenectomy is well established. In view of this, surgical responsibility must embrace the administration of pneumococcal prophylaxis. Current recommendations vary, but routine pneumococcal vaccination, together with penicillin prophylaxis in selected patients, is advocated widely. This retrospective review of 75 patients undergoing splenectomy was undertaken in order to evaluate the extent to which current practice complies with these recommendations. Among surviving patients, the incidence of vaccination with polyvalent pneumococcal vaccine (PPV) was found to vary according to operative indication. All haematological patients received pre-operative PPV. Two-thirds of multitrauma patients were vaccinated, while 42% of patients who required splenectomy following accidental intra-operative trauma received PPV. Only 11% of patients who underwent incidental splenectomy were vaccinated. Long-term antibiotic prophylaxis was commenced in 33% of surviving patients under 20 years of age, and in 8% with underlying malignancy. These results highlight a need for greater vigilance in the administration of pneumococcal prophylaxis, particularly following accidental or incidental splenectomy.
Gov't Doc #: 2183753
Journal: Australian and New Zealand Journal of Surgery
Type: Journal Article
Subjects: Adult
Bacterial Vaccines.therapeutic use
Middle Aged
Penicillins.therapeutic use
Pneumococcal Infections.prevention & control
Retrospective Studies
Streptococcus pneumoniae.immunology
Appears in Collections:Journal articles

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