Asplenia primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kalpana Giri, MBBS[2]


Effective measures for the primary prevention of infection in asplenic patients include immunizations against Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), and Neisseria meningitidis, antibiotic prophylaxis, and malaria prophylaxis.

Primary Prevention


Antibiotic prophylaxis

  • Only Immunizations do not protect against infections with encapsulated bacteria, antibiotic prophylaxis Should be given. All the patients younger than five years of age should receive antibiotic prophylaxis.[2]
  • For children
    • Birth to three months: Escherichia coli, Klebsiella is of concern in this age group.[4]
      • Amoxicillin or clavulanate 10 mg/kg/dose PO q12h, with penicillin VK 125 mg per dose PO q12h OR amoxicillin 10 mg/kg/dose q12h, as an alternative, if not tolerated.
    • more than 3 months to five years:
      • Penicillin VK 125 mg per dose PO q12h OR amoxicillin 10 mg/kg/dose PO q12h.
    • more than 5 years:
      • Penicillin V 250 mg or 300 mg per dose q12h OR amoxicillin 250 mg per dose q12h.

Malaria prophylaxis

  • Asplenic and hyposplenic children must be advised to take malaria prophylaxis as appropriate for their age and the type of malaria found in the area to which they are traveling and they should always seek travel advice due to the increased risk of severe malaria in these patients.[4]


  1. Waghorn DJ (2001). "Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed". J Clin Pathol. 54 (3): 214–8. doi:10.1136/jcp.54.3.214. PMC 1731383. PMID 11253134.
  2. 2.0 2.1 Salvadori MI, Price VE, Canadian Paediatric Society, Infectious Diseases and Immunization Committee (2014). "Preventing and treating infections in children with asplenia or hyposplenia". Paediatr Child Health. 19 (5): 271–8. PMC 4029242. PMID 24855431.
  3. Huebner ML, Milota KA (2015). "Asplenia and fever". Proc (Bayl Univ Med Cent). 28 (3): 340–1. doi:10.1080/08998280.2015.11929267. PMC 4462215. PMID 26130882.
  4. 4.0 4.1 Committee to Advise on Tropical Medicine and Travel (CATMAT) (2009). "Canadian recommendations for the prevention and treatment of malaria among international travellers--2009". Can Commun Dis Rep. 35 Suppl 1: 1–82. PMID 19750611.
  5. Quéffélec C, Billet L, Duffau P, Lazaro E, Machelart I, Greib C; et al. (2020). "Prevention of infection in asplenic adult patients by general practitioners in France between 2013 and 2016 : Care for the asplenic patient in general practice". BMC Fam Pract. 21 (1): 163. doi:10.1186/s12875-020-01237-3. PMC 7425533 Check |pmc= value (help). PMID 32787857 Check |pmid= value (help).

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