Authors: A J J Lammers D Veninga M J M H Lombarts J B L Hoekstra P Speelman
Publish Date: 2010/01/22
Volume: 29, Issue: 4, Pages: 399-405
Abstract
After splenectomy patients are at increased risk of sepsis with considerable mortality The risk of sepsis can be reduced by immunising these patients and by prescribing antibiotic prophylaxis The purpose of our study was to determine compliance with the international standards for the management of splenectomised patients in the Netherlands by investigating i vaccination rates ii the prescription of antibiotics and iii information in discharge letters A retrospective review of the medical records and discharge correspondence of 609 splenectomy patients from 1997 to 2008 was performed Data were collected from 28 hospitals Adherence to vaccination guidelines and the prescription of antibiotics were assessed It was found that 854 of postsplenectomy patients received pneumococcal vaccination 394 received Haemophilus influenzae type B and 323 received meningococcal group C vaccination Also 124 of patients were discharged on prophylactic antibiotics In less than 25 of cases were adequate recommendations regarding postsplenectomy management given to the general practitioner GP In the Netherlands compliance with recommendations for the management of patients after splenectomy is insufficient Fifteen percent of patients do not receive vaccination against pneumococci and the majority of patients do not receive antibiotic prophylaxis The development and implementation of a national guideline for splenectomised patients is urgently required
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