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Antibiotics and vaccination in sickle cell disease

Authoring team

Prophylaxis with daily oral penicillin reduces the rate of pneumococcal infection and the mortality rate (1)

Prophylaxis should commence by the age of 3 months (when the level of fetal haemoglobin starts to reduce & the risk of splenic hypofunction increases) and should be continued throughout childhood (2).

Recommended doses of oral penicillin are (erythromycin may be used in patients with penicillin allergy):

  • 62.5 mg daily up to age 1 year
  • 125 mg daily up to age 3 year
  • 250 mg daily thereafter (2)

Pneumococcal vaccination should be given as soon as possible after diagnosis (1)

  • a conjugated pneumococcal polysaccharide vaccine - this is immunogenic in the very young and is licensed for use in the under 6 month old
  • 23-valent polysaccharide vaccine - only weakly immunogenic in children under 2 years old - should be used in older children
    • usually at 2-3 years old, then every 5 years

All the other vaccines in the routine infant immunisation programme should be given:

  • hepatitis B immunisation should also be offered to non immune children (2)
  • children should also be immunised each autumn against influenza

Reference:


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