3.13.3 - Splenectomy Vaccination and Antimicrobial Prophylaxis [New]

Vaccination Recommendations*, **

Antibiotic prophylaxis

 recommendation

Pneumococcal

Meningococcal

Haemophilus influenzae type b

Influenza

1 dose of PCV 13, followed by 1 dose of PPV23 at least 8 weeks after PCV13

Booster doses of PPV23 at least 5 years after the last PPV23 vaccine

Final dose of PPV23 is given at least 5 years later or at age 60 years, whichever is later

Quadrivalent (ACWY) conjugate vaccine, 2 doses, 8 weeks apart

Followed by booster dose every 5 years

Single dose for those who have not received/completed Hib vaccination in childhood

Annual vaccination

Patient needs to be on penicillin prophylactic antibiotic for at least 1-year post-splenectomy, OR as long as patient is immunocompromised due to other conditions.

Suggested option: Oral penicillin V 250 mg BD

For patients with mild non-IgE-mediated reactions to penicillin: Cephalexin 250 mg BD. Otherwise, azithromycin 250 mg OD

If the individual has received PPV23 vaccine before, PCV13 vaccine should be given at least 1 year after the previous dose of PPV23

2nd dose of PPV23 vaccine at least 5 years after the last PPV23 vaccine

A final dose of PPV23 is given at least 5 years later or at age 60 years, whichever is later

 

 

                            

Patient needs to be supplied with rescue antibiotic. This is to be taken upon febrile episode while seeking medical attention at the same time.

Suggested option: Augmentin































 

*For elective splenectomy, vaccinations should ideally be started 10 to 12 weeks prior to surgery, so that the recommended vaccine series can be completed at least 14 days prior to splenectomy. If all recommended vaccine series cannot be completed in this time period, vaccine series can be resumed 14 days after splenectomy for most patients. For patients who will receive chemotherapy or other immunosuppressive treatment following splenectomy, vaccinations are usually resumed approximately 3 months after that treatment

 

**For patients undergoing emergency splenectomy, vaccine series should be started 14 days after splenectomy.