4.13.2 - Non Surgical





Neisseria meningitides
Household and close contact
Ciprofloxacin 500 mg PO as single dose
Ceftriaxone 250 mg IM as single dose
Rifampicin 600 mg PO q12H for 2 days

Avoid rifampicin in pregnancy.

Close contacts: have had contact with oropharyngeal secretions (e.g. kissing, sharing toys, beverages, cigarettes, intubating).
Upper GI bleeding in cirrhosis

Ciprofloxacin 500 mg PO q12H 2 - 7 days

Ceftriaxone 1 gm IV q24h for 7 days
Spontaneous bacterial peritonitis
Indication: Previous proven SBP acsitic protein < 10 g/L

TMP-SMX (80 mg / 400 mg) 2 tablet PO q24H
Norfloxacin 400 mg PO q24H
Ciprofloxacin 500 mg PO q12H

Only use norfloxacin if trimethoprim-sulfamethoxazole failed.
Asplenia Or Hyposlenia
Pathogen: encapsulated bacteria prophylaxis, recommended for: < 5 year, at least year 3 years post splenectomy, underlying immunocompromised, at least 6 months after an episode of severe sepsis.

Amoxycillin 250 mg PO q12H
Phenoxymethylpenicillin 250 - 500 mg PO q12H
Erythromycin Ethyl Succinate 400 mg PO q24H

Emergency supply of antibiotic for self administration when febrile while seeking physician

Amoxycillin 3 gm PO
Amoxycillin / Clavulanate 625 mg PO
If taking EES, increase dose to 800 mg PO q12H
Cefuroxime 1 gm PO
Clindamycin 600 mg PO
TMP-SMX (TMP 80 mg / SMX 400 mg) 2 tablet PO

Vaccination recommendation:
Pneumococcal vaccine

Meningococcal vaccines

Hemophilus influenzae type B Influenza

Pneumococcal 23-valentpolysaccharidevaccine 0.5 mL S/C or IM, 5 yearly

Meningococcal quadrivalent polysaccharide ACWY vaccine 0.5 mL S/C, 5 yearly
Hib 0.5 mL IM, Single dose

Influenza vaccine annually

> 2 weeks before elective surgery 
OR 7 - 14 days after emergency splenectomy or prior to discharge.