AB profilaxis esplenectomia

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No prophylaxis is my practice.

Ronald I. Gross, MD, FACS
Chief of Trauma & Emergency Surgery Services
Baystate Medical Center
759 Chestnut Street
Springfield, MA  01199
413-794-4022  phone
413-794-0142  fax
ronald.gross at bhs.org


-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Richard van der Kleyn
Sent: Saturday, January 24, 2009 9:30 AM
To: trauma-list at trauma.org
Subject: AB profilaxis esplenectomia



A quick question for the trauma gurus: Have a friends mum, 82 yo, very healthy (gym every morning), 2 episodes of TIA (transient ischemic attaques) on asprin 75 mg + atorvastatin, splenectomia 10 years ago after falling of a bicycle, pneumokok vacinations up to date. her GP has now put her on penicilin 500 td profilaxis (up until now only took peniciline when she felt ill or if people around her were sick).

did a quick research into the us of continuous AB profilaxis in the esplenic pacient, in children seams to be the standard of care but in adults no concensus.

Questions

1) do you think esplenic adults should take profilaxtic AB? or thus this lead to more chance of a AB resistent infecion?

2) if so which antibiotic: penicilin or something that cover gram pos. bacteria better (ciprofloxacin/levofloxacin) ?

Thanks in advance for any advice

Richard van der Kleyn
metge adjunt servicio de urgencias
hospital de Figueres.
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