Prophylactic penicillin after 5 years of age in patients with sickle cell disease: A survey of sickle cell disease experts1. Issue 6 (28th November 2012)

• Record Type: Journal Article
• Authors: McCavit, Timothy L.; Gilbert, Megan; Buchanan, George R.
• Is Part Of: Pediatric blood & cancer. Volume 60:Issue 6(2013:Jun.)
• Page Start: 935
• Page End: 939
• Publication Date: 2012-11-28
• Subjects: Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.24395
• Languages: English
• ISSNs: 1545-5009

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="abs1-1" sec-type="section"> <title>Background</title> <p>Since the publication of the Prophlyactic Penicillin Study II in 1995, the management of penicillin prophylaxis for children with sickle cell disease (SCD) after 5 years of age has been controversial. In this study, we sought to describe current practice patterns of pediatric hematologists related to cessation of penicillin prophylaxis for children with SCD after 5 years of age.</p> </sec> <sec id="abs1-2" sec-type="section"> <title>Procedure</title> <p>We performed a cross‐sectional, electronic survey of pediatric hematologists with expertise in SCD to examine practices regarding penicillin prophylaxis in children with SCD after 5 years of age. We also investigated factors potentially associated with continuation of penicillin prophylaxis using the Jonckheere–Terpstra test and Fisher's exact test.</p> </sec> <sec id="abs1-3" sec-type="section"> <title>Results</title> <p>Of the 106 physicians surveyed from 76 centers, 84% completed the survey. Among respondents, 76% routinely recommended cessation of penicillin prophylaxis after 5 years of age. The practice of routinely continuing penicillin after 5 years of age was associated with decreased concern about antibiotic resistance in <italic>Streptococcus pneumoniae</italic> (<italic>P</italic> = 0.01), with the usage of prophylactic penicillin in mild SCD genotypes (sickle hemoglobin‐C disease and sickle β<sup>+</sup> thalassemia, <italic>P</italic> = <0.001), and with increasing use of other preventive evaluations (e.g., MRI for silent stroke) in childhood (<italic>P</italic> = 0.05).</p> </sec> <sec id="abs1-4" sec-type="section"> <title>Conclusion</title> <p>Most pediatric hematologists with an SCD expertise recommend cessation of prophylactic penicillin after 5 years of age. Pediatr Blood Cancer 2013; 60: 935–939. © 2012 Wiley Periodicals, Inc.</p> </sec> </abstract>