YOU ARE NOW CONNECTED TO THE TOXLINE (1981 FORWARD, NON-ROYALTY) FILE. ==SPLENECTOMY PROPHYLAXIS== 1 AUTHOR Brew I AUTHOR Adisesh A TITLE Post-splenectomy sepsis - The role of occupational health SOURCE Occupational Medicine June 1996, Vol.46, No.3, p.231-232. 6 ref. ABSTRACT The risks of serious infection in persons who have had their spleens removed (asplenics) are described along with the prophylaxis available and the role of the occupational health department in protecting asplenic employees. The importance of vaccination is stressed, particularly in employees travelling abroad. 2 AUTHOR Palejwala AA AUTHOR Hong LY AUTHOR King D TITLE Managing patients with an absent or dysfunctional spleen: under half of doctors know that antibiotic prophylaxis should be life long SOURCE Br. Med. J.; VOL 312 ISS May 25 1996, P1360, (REF 2) ABSTRACT IPA COPYRIGHT: ASHP The results of a survey evaluating physician knowledge of the infection susceptibilities and antibiotic prophylaxis needs of splenectomized patients are reported; 69 hospital doctors and 49 general practice physicians participated in the survey. Most respondents knew that splenectomized patients were at increased risk of pneumococcal infection, but only half of the hospital doctors and one-third of the general practitioners knew that these patients were at risk of meningococcal infection and malaria. Most of the respondents knew about the risk of Haemophilus influenzae infection. Although there was general awareness about antibiotic prophylaxis, only 7 general practitioners and 34 hospital doctors knew that this prophylaxis should be lifelong. It was concluded that awareness and implementation of guidelines for preventing and treating infection in patients with an absent or dysfunctional spleen is essential. 10 AUTHOR anon TITLE Infectious problems after elective surgery of the alimentary tract: influence of peri-operative factors SOURCE Curr. Med. Res. Opin.; VOL 11 ISS Mar 1988, P179-195, (REF 35) ABSTRACT IPA COPYRIGHT: ASHP A prospective multi-center study in 1537 patients (845 females; mean age 58.6 yr) to investigate the influence of some peri-operative factors on the infectious complications after elective abdominal surgery with administration of a prophylactic regimen of 1600 tinidazole (Fasigyn) plus 400 mg doxycycline hyclate (Vibramycin) by intravenous injection one h pre-operatively, is described. Results showed that total gastrectomy seemed to give higher infection rates than other gastroduodenal procedures. Low anterior and abdomino-perineal rectal resections were followed by more infectious complications than colonic resections, but this difference was significant only due to the perineal wound infections and failures of the low anterior anastomosis. Prolonged operation time was followed by increased number of infectious complications only when prophylaxis was not given. Blood transfusions led to a highly significant increase in infectious complications. Peri-operative surgical complications, splenectomy and stoma formation did not influence post-operative infectious complications. 11 AUTHOR Zarrabi MH AUTHOR Rosner F TITLE Rarity of failure of penicillin prophylaxis to prevent postsplenectomy sepsis SOURCE Arch. Intern. Med.; VOL 146 ISS Jun 1986, P1207-1208, (REF 18) ABSTRACT IPA COPYRIGHT: ASHP A review of the effectiveness of penicillin (I) prophylaxis in 14 asplenic patients, 13 children and one adult, was reported. In only 5 cases, the patients had I-sensitive pneumococcal infection. Hence, the exact frequency of the failure of I prophylaxis cannot be calculated, but it appeared to be very rare. It was concluded that continuous antibiotic prophylaxis used indefinitely and pneumococcal vaccine are both strongly recommended for all children and adults undergoing splenectomy. 14 AUTHOR Brivet F AUTHOR Herer B AUTHOR Fremaux A AUTHOR Dormont J AUTHOR Tchernia G TITLE Fatal post-splenectomy pneumococcal sepsis despite pneumococcal vaccine and penicillin prophylaxis SOURCE Lancet; VOL 2 ISS Aug 11 1984, P356-357, (REF 4) ABSTRACT IPA COPYRIGHT: ASHP A case of fatal pneumococcal sepsis in a 66-yr-old splenectomized woman despite pneumococcal vaccine (Pneumovax), and penicillin V (phenoxymethylpenicillin) prophylaxis is reported. It was concluded that serious pneumococcal infection in asplenic patients is possible even when the patient has been vaccinated and is taking penicillin prophylaxis.