Table 1.

Antibiotic prophylaxis for patients with asplenia

Routine prophylaxis* 
 <3 y PCN VK 125 mg twice daily (or amoxicillin 10 mg/kg by mouth twice daily) 
 ≥3 y PCN VK 250 mg twice daily 
 Adults PCN VK 250 mg by mouth twice daily (or amoxicillin 500 mg by mouth twice daily) 
 Adults with PCN allergy Cephalexin 250 mg by mouth twice daily 
Azithromycin 250 mg by mouth once daily 
Emergency antibiotics before ED arrival 
 Child Amoxicillin-clavulanate 45 mg/kg by mouth twice daily (maximum 875 mg per dose) 
 Child with PCN allergy Cefdinir 7 mg/kg by mouth twice daily (max 300 mg per dose) 
Levofloxacin 10 mg/kg by mouth twice daily (max 375 mg per dose) 
 Adult Amoxicillin-clavulanate 875 mg/125 mg by mouth twice daily 
 Adult with PCN allergy Cefdinir 300 mg by mouth twice daily 
Levofloxacin 750 mg by mouth once daily 
Moxifloxacin 400 mg by mouth once daily 
Preprocedural prophylaxis (for sinus surgery or airway procedure) 
 Child Amoxicillin 50 mg/kg 1 h before procedure (max 2 gram) 
 Adult Amoxicillin 2 g 30-60 min before procedure 
Routine prophylaxis* 
 <3 y PCN VK 125 mg twice daily (or amoxicillin 10 mg/kg by mouth twice daily) 
 ≥3 y PCN VK 250 mg twice daily 
 Adults PCN VK 250 mg by mouth twice daily (or amoxicillin 500 mg by mouth twice daily) 
 Adults with PCN allergy Cephalexin 250 mg by mouth twice daily 
Azithromycin 250 mg by mouth once daily 
Emergency antibiotics before ED arrival 
 Child Amoxicillin-clavulanate 45 mg/kg by mouth twice daily (maximum 875 mg per dose) 
 Child with PCN allergy Cefdinir 7 mg/kg by mouth twice daily (max 300 mg per dose) 
Levofloxacin 10 mg/kg by mouth twice daily (max 375 mg per dose) 
 Adult Amoxicillin-clavulanate 875 mg/125 mg by mouth twice daily 
 Adult with PCN allergy Cefdinir 300 mg by mouth twice daily 
Levofloxacin 750 mg by mouth once daily 
Moxifloxacin 400 mg by mouth once daily 
Preprocedural prophylaxis (for sinus surgery or airway procedure) 
 Child Amoxicillin 50 mg/kg 1 h before procedure (max 2 gram) 
 Adult Amoxicillin 2 g 30-60 min before procedure 

ED, emergency department; PCN VK, penicillin V potassium.

*

Duration of routine prophylaxis depends on age, time since splenectomy, degree of immunocompromise, or prior episode of sepsis.

or Create an Account

Close Modal
Close Modal