title: Adherence to preventive measures after splenectomy in the hospital setting and in the community.
abstract: Overwhelming post-splenectomy infection (OPSI) remains a long-term risk in asplenic patients, which may be reduced by appropriate preventive measures. Specific guidelines have been developed to lower its incidence.
  
  
  OBJECTIVE
  To assess the implementation of guidelines by specialized physicians of a university hospital and primary care physicians.
  
  
  METHODS
  A retrospective review of splenectomized patients' medical files over a six year period was carried out. Patients' general practitioners were contacted and a questionnaire was sent to them.
  
  
  RESULTS
  154 individuals who underwent splenectomy between 2000 and 2005 were eligible (62 children and 92 adults): 70.8% received pneumococcal vaccine, 44% received vaccine against Haemophilus influenzae type b with a good cover of children population (88.7%), 24% received meningococcal vaccine. Prophylactic antibiotics were prescribed in 74% of patients. Septic events were found in 8.4%, and global mortality was 11.7% during a mean follow-up period of 4.5 years.
  
  
  CONCLUSIONS
  Management of the infectious risk in asplenic patient has to be improved: some of the patients are not correctly identified as at risk of OPSI, and vaccination against Neisseria meningitidis is insufficient. Hospital specialists should improve the implementation of guidelines and give better information to general practitioners involved.
authors: Paris Descartes University, Paris, France.
authors: Hélène
authors: H
authors: Coignard-Biehler
authors: Fanny
authors: F
authors: Lanternier
authors: Arnaud
authors: A
authors: Hot
authors: Dominique
authors: D
authors: Salmon
authors: Anne
authors: A
authors: Berger
authors: Marianne
authors: M
authors: de Montalembert
authors: Felipe
authors: F
authors: Suarez
authors: Odile
authors: O
authors: Launay
authors: Marc
authors: M
authors: Lecuit
authors: Olivier
authors: O
authors: Lortholary
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D001424:Bacterial Infections / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control*; D001428:Bacterial Vaccines / Q000008:administration & dosage / Q000276:immunology; D002648:Child; D005260:Female; D019983:Guideline Adherence; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010297:Paris; D058007:Physicians, Primary Care; D011183:Postoperative Complications / Q000188:drug therapy / Q000401:mortality / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D013156:Splenectomy / Q000009:adverse effects*; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001428:Bacterial Vaccines