1. Long term antibiotic prophylaxis (Phenoxymethylpenicillin Or erythromycin)
2. Polyvalent Pneumococcal Vaccine ( Pneumovax 23) 0.5ml SC Q 6 years
3. Quadravalent Meningococcal Polysaccharide Vaccine (Menomune) 0.5 ml SC Q 3-5 years
4. H.Influenza b vaccine (Hib TITER) 0.5 ml IM
5. Vaccinations should be administered 3 days post-splenectomy or the day prior to discharge, whichever comes first, unless patient remains in the ICU. 1,2
6. Vaccinations should be administered post-ICU stay. “Although there are no data on the optimum timing of vaccine given postoperatively, it is logical to give it at time of discharge, thus minimizing the immunosuppressive effect of surgery.” 3
7. Elective splenectomy patients should be vaccinated atleast 14 days prior to the surgery.
8. Asplenic or immunocompromised patients (with an intact but non-functional spleen) should be vaccinated as soon as the diagnosis is made.
9. Revaccination of Pneumovax every 6 years. (CDC Guidelines) No data to support the same for Hib or Menomune.
References
1. Shatz DV, Romero-Steiner S, Elie CM, Holder PF, Carlone GM. Antibody responses in postsplenectomy trauma patients receiving the 23-valent pneumococcal polysaccharide vaccine at 14 versus 28 days postoperatively. J Trauma. 2002 Dec; 53(6): 1037-42.
2. Shatz DV. Schinsky MF. Pais LB. Romero-Steiner S. Kirton OC. Carlone GM. Immune responses of splenectomized trauma patients to the 23-valent pneumococcal polysaccharide vaccine at 1 versus 7 versus 14 days after splenectomy. [Clinical Trial. Journal Article. Randomized Controlled Trial] Journal of Trauma-Injury Infection & Critical Care. 44(5): 760-5; discussion 765-6, 1998 May.
3. Working Party of the British Committee for Standards in Haematology Clinical Haematology Task Force. Guidelines for the prevention and treatment of infection in patients with an absent of dysfunctional spleen. BMG. 1996 Feb 17;312(7028):430-4.
4. http://docserver.ingentaconnect.com/
