Infection Prophylaxis

Also known as: antibiotic prophylaxis, antimicrobial prophylaxis.

What is infection prophylaxis?

Infection prophylaxis is the idea of using antibiotics and other infection-fighting medications prior to the infection occurring to help prevent it. This approach is commonly used before a surgical procedure that can cause infections, or in patients who are more prone to infections. In patients with sickle cell disease, the spleen does not work properly or at all. The problem makes people who have sickle cell disease more likely to get severe infections. Infection prophylaxis is a potential remedy and standard treatment.

What happens during the treatment?

Infection prophylaxis can take on several different forms. For patients with sickle cell disease, taking penicillin two times a day has been shown to reduce the chance of having severe infections caused by pneumococcus bacteria. Infants need to take liquid penicillin, but older children can take tablets.

Many doctors will stop prescribing penicillin after a child has reached the age of 5. Some prefer to continue this antibiotic throughout life, particularly if a person has hemoglobin SS or hemoglobin SBO thalassemia, since people with the sickle cell disease are still at risk. All people who had surgical removal of the spleen, called a splenectomy, or past infection with pneumococcus should keep taking penicillin throughout life. People who have sickle cell disease should receive all recommended childhood vaccines. They should also receive additional vaccines to prevent other infections.

Is any special preparation needed?

Preparations for infection prophylaxis vary based on the specific medication regimen that is recommended. When penicillin prophylaxis is used past the age of 5, the families need to be educated on infections due to resistance to penicillin.

What are the risk factors?

The risks and side effects will vary based on what medications are prescribed. Infection may still be a potential risk even after the administration of infection prophylaxis.

  • Influenza: All people who have sickle cell disease should receive a flu shot every year at the start of the flu season. This vaccination should begin at 6 months of age. Only the inactivated vaccine, which comes as a shot, should be used in people with sickle cell disease.
  • Meningococcus: A child who has sickle cell disease should receive a meningococcal vaccine at 2, 4, 6 and 12-15 months. The child should receive a booster vaccine three years after the series of shots, then every 5 years after that.
  • Pneumococcus: Even though all children routinely receive the vaccine against pneumococcus (PCV13), your child’s doctor may recommend a second kind of vaccine against pneumococcus (PPSV23). This second vaccine is given after 24 months of age and again five years later. Adults who have sickle cell disease who have not received any pneumococcal vaccine should get a dose of the PCV13.

Reviewed by: Athena C Pefkarou, MD

This page was last updated on: November 06, 2020 02:37 PM

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