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An audit of post-splenectomy prophylaxis--are we following the guidelines?
Jyothi Ramachandra1, Amanda Bond, Charles Ranaboldo
1Department of General Medicine, Salisbury District Hospital, Salisbury, Wiltshire, UK.
Introduction:
Asplenic individuals have major difficulties coping with specific infections (e.g. Streptococcus pneumoniae). This is an audit to look at a district general hospital's compliance with published guidelines for immunisations and antibiotic prophylaxis post-splenectomy.
Patients And Methods:
A retrospective review of hospital records of consecutive splenectomy patients from January 1996 to March 2001.
Results:
Of 76 patients, 72% were vaccinated (30/76 with pneumococcal, HIB and meningococcal vaccines, 15/76 with Pneumovax and HIB, 10/76 with Pneumovax only), 63% were discharged on prophylactic antibiotics, and 81% of surviving patients had adequate communication with the GP regarding splenectomy. Patients undergoing non-elective splenectomy were less likely to be vaccinated or receive prophylactic antibiotics when compared with elective splenectomy patients.
Conclusions:
Results are comparable with other published studies, but are still unsatisfactory for many splenectomy patients. Vaccination rates must be improved and more information given to patients and GPs to allow for appropriate follow-up care.