The value of prophylactic vaccinations and antibiotic treatment in post-splenectomy patients: a review

Lammers, A J Jolanda

doi:10.2147/trrm.s25198

Cited by 2 publications

(1 citation statement)

References 53 publications

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“…Regarding vaccination against Neisseria meningitides , the vaccination rate was higher in our study than in other previously published results [ 10 , 23 , 25 ], as was the rate of vaccination against HIB [ 10 , 16 , 18 , 22 , 23 , 25 ]. Of note, the low vaccination rate against B serogroup can be partly explained by the evolution of guidelines in France, as the anti-MenB vaccine was recommended for asplenic patients in 2013 and reimbursed by the Sécurité Sociale in December 2014.…”

Section: Discussioncontrasting

confidence: 87%

Prevention of infection in asplenic adult patients by general practitioners in France between 2013 and 2016

Quéffélec¹,

Billet²,

Duffau³

et al. 2020

BMC Fam Pract

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Background Guidelines that detail preventive measures against Streptococcus pneumoniae , Neisseria meningitidis , Haemophilus influenzae type b, and influenza are published annually in France to decrease the risk of severe infections in immunocompromised patients. We aimed at describing adherence to these guidelines by GPs in the management of their asplenic patients in France between 2013 and 2016. Method We conducted a multicenter retrospective study between January 2013 and December 2016 in three French hospitals: asplenic adults were identified and their GPs were questioned. A descriptive analysis was performed to identify the immunization coverage, type and length of antibiotic prophylaxis, number of infectious episodes, and education of patients. Results 103 patients were finally included in this study: only 57% were adequately vaccinated against Streptococcus pneumoniae or Neisseria meningitidis , 74% against Haemophilus influenzae type b, and 59% against influenza. Only 24% of patients received a combination of all four vaccinations. Two-thirds of patients received prophylactic antibiotics for at least 2 years. Overall, this study found that 50% of splenectomized patients experienced at least one pulmonary or otorhinolaryngological infection, or contracted influenza. Conclusions These data match those reported in other countries, including Australia and the United Kingdom, meaning a still insufficient coverage of preventive measures in asplenic patients. Improved medical data sharing strategies between healthcare professionals, along with educational measures to keep patients and physicians up to date in the prevention of infections after splenectomy would improve health outcomes of asplenic patients.

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Section: Discussioncontrasting

confidence: 87%

Prevention of infection in asplenic adult patients by general practitioners in France between 2013 and 2016

Quéffélec¹,

Billet²,

Duffau³

et al. 2020

BMC Fam Pract

View full text Add to dashboard Cite

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Adherence to vaccination guidelines post splenectomy: A five year follow up study

Boam

Sellars

Isherwood³

et al. 2017

Journal of Infection and Public Health

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Following a splenectomy patients are at increased risk of significant infections. In its most severe form, overwhelming post-splenectomy infection (OPSI) has a mortality rate of up to 80%. In this study we aim to establish the adherence to vaccination and antibiotic national guidelines in splenectomised patients. A retrospective study of 100 patients who underwent splenectomy (21 emergency, 79 elective), in two teaching hospitals was undertaken over a five-year period. Patients were followed up for five years. Hospital and GP records were reviewed for adherence to pre, intra and postoperative vaccination, thromboprophylaxis and antibiotic guidance. Eighty-six eligible patients (91.5%) received their Haemophilus influenzae B, meningococcal C and pneumococcus vaccinations peri-operatively. Eighty-one (86%) received post-operative antibiotics. Ninety-nine percent of patients received thromboprophylaxis treatment. Eighty-nine (95%) were treated with long-term antibiotic prophylaxis. Only 20 patients (23%) had an emergency supply of antibiotics. Ninety-five percent of patients were administered an annual influenza vaccination and 84% of eligible patients received a five-year pneumococcal booster vaccination. Improvement in the management of this patient cohort can be achieved by a multidisciplinary approach involving adherence to national guidelines, standardised trust protocols, patient information leaflets and advice detailing risk of infection, standardised GP letters and a splenectomy register to monitor and manage this vulnerable group of patients.

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The value of prophylactic vaccinations and antibiotic treatment in post-splenectomy patients: a review

Cited by 2 publications

References 53 publications

Prevention of infection in asplenic adult patients by general practitioners in France between 2013 and 2016

Prevention of infection in asplenic adult patients by general practitioners in France between 2013 and 2016

Adherence to vaccination guidelines post splenectomy: A five year follow up study

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