Abstract
Septicemia due to S. pneumoniae is a well known complication of splenectomy or splenic dysfunction. Although prophylactic oral P is often recommended as a supplement to patient education and pneumococcal vaccine as a means of preventing these serious and often fatal infections, poor patient compliance is used as an argument against this approach. Therefore, we studied compliance during a 10 mo. period in 43 high risk patients, 27 of whom were infants or young children with sickle cell anemia, 15 with prior splenectomy, and 1 after bone marrow transplant. Median age was 3 yr. (range 6 mo. to 19 yr.). All were instructed and most were regularly reminded to take P twice daily. Without knowledge of the patients or their parents, urine obtained at one or more clinic visits was tested for P by the Sarcina lutea inhibition method. 50 of 76 (66%) samples contained P. Of the 43 patients, 32 (76%) had urines positive for P at least once. 19 of 20 patients tested multiple times were positive on at least one occasion. Parents of children whose initial urines were negative for P were provided with written and verbal reminders, and repeat urines tended to be positive. Compliance was not clearly related to age, duration of P administration, diagnosis, or number of clinic visits. Based on these data, we conclude that poor patient compliance is not a valid argument against use of prophylactic oral P in patients at high risk of pneumococcal septicemia.
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Buchanan, G., Siegel, J., Smith, S. et al. 40 ORAL PENICILLIN (P) PROPHYLAXIS IN CHILDREN WITH IMPAIRED SPLENIC FUNCTION: A STUDY OF COMPLIANCE. Pediatr Res 15 (Suppl 4), 446 (1981). https://doi.org/10.1203/00006450-198104001-00049
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DOI: https://doi.org/10.1203/00006450-198104001-00049