Surgery>>>>>Spleen
Question 19#

Which of the following asplenic patients should receive prophylactic antibiotic therapy to protect against OPSI?

A. A 35-year-old man undergoing a tooth extraction
B. A 4-year -old child who recently underwent splenectomy
C. A 15-year-old boy who underwent splenectomy at age 13
D. There is little evidence supporting efficacy of prophylactic antibiotics

Correct Answer is D

Comment:

Antibiotic therapy in asplenic patients falls into three categories: deliberate therapy for established or presumed infections, prophylaxis in anticipation of invasive procedures, and general prophylaxis. There is little evidence supporting efficacy of prophylactic antibiotics in anticipation of invasive procedures or efficacy of general prophylaxis and guidelines are not uniform. Common recommendations include daily antibiotics until 5 years of age or at least 5 years after splenectomy with some advocating continuing antibiotics until young adulthood, however, there is little evidence supporting efficacy. It is unlikely that randomized controlled trials on this issue will be performed due to the low incidence of overwhelming postsplenectomy infection as well as its serious consequences.