Post-splenectomy antibiotic prophylaxis--unfinished story: to treat or not to treat?
Overwhelming infection in asplenic patients is a well documented occurrence in the literature. The introduction of immunization with polyvalent pneumococcal, Hemophilus Influenza and meningococcal vaccines significantly cut down the incidence of post-splenectomy sepsis and mortality. However, the issue of prophylactic antibiotic therapy in these patients remains inconclusive. There are contradictory reports bouncing between life-long treatment to no treatment. There are also more flexible approaches emerging from patient difficulties complying with a prolonged therapy. This debate calls for developing a better predictive approach based on genetic profiling of patients with different susceptibility to infectious pathogens, host-pathogens interactions as well as to identify the impact of factors such as age, on immunological competence.
Kaplinsky
Chaim
C
Department of pediatric hematology oncology, Edmond and Lily Safra Children's Hospital, Tel Hasomer, Israel. chaim.kaplinsky@sheba.health.gov.il
Spirer
Zvi
Z
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000235:genetics / Q000517:prevention & control*; D020022:Genetic Predisposition to Disease; D006801:Humans; D016233:Immunotherapy, Active; D013156:Splenectomy / Q000009:adverse effects
D000900:Anti-Bacterial Agents