Головна Undefined

splenectomy

Content version
U-217.2
Updated
10/20/2025 - 12:35

Recommendations

≥ 18 years
Дозування Ремарки
phenethicillin oral 250 mg twice daily

SWAB remarks

First 2 years after splenectomy
amoxicillin + clavulanic acid oral 500/125 mg three times daily

SWAB remarks

On-demand
amoxicillin + clavulanic acid oral 500/125 mg three times daily for 7 days

SWAB remarks

For animal bite
≥ 18 years

Indications: Beta-lactam allergy
Дозування Ремарки
azithromycin oral 250 mg three times weekly

of

clarithromycin oral 500 mg once daily

SWAB remarks

First 2 years after splenectomy
clarithromycin oral 500 mg twice daily

of

moxifloxacin oral 400 mg once daily

SWAB remarks

On-demand; moxi for maintenance macrolides
clindamycin oral 600 mg three times daily for 5 days

+

ciprofloxacin oral 500 mg twice daily for 5 days

SWAB remarks

For animal bite

Comments

Vaccinations in adults: the following vaccinations are recommended:

Administer at least 2 weeks before splenectomy if possible, otherwise 2 weeks after splenectomy:

  • PCV13: once (catch up if not previously received)
  • PPV23: once (2 months after PCV13). Thereafter repeat every 5 years
  • Hib: once (catch up if not previously received)
  • MenACWY: once (catch up if not previously received). If < 24 years single revaccination after 3-5 years
  • MenB: 2 doses
  • Influenza: annually

 

Antibiotics - adults

Continuous prophylactic antibiotics are advised for the first 2 years after splenectomy.

Thereafter on-demand and for animal bites.

In adults who do not have an immediate high risk of OPSI it may be considered not to give prophylaxis during the first 2 years after splenectomy but to switch immediately to on-demand antibiotic use.

In adults with a partial splenectomy or in adults with functional asplenia it may be considered to omit prophylactic antibiotics and to start directly with on-demand use.

In patients with a high risk of OPSI, such as splenectomy for haematological malignancy, prolonged use of immunosuppressive medication, or a previous OPSI, consider extending the duration of prophylactic antibiotics in consultation with the treating physician.