Abstract
Background: 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. Procedure: 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. Results: 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 Streptococcus pneumoniae (P=0.01), with the usage of prophylactic penicillin in mild SCD genotypes (sickle hemoglobin-C disease and sickle β+ thalassemia, P=<0.001), and with increasing use of other preventive evaluations (e.g., MRI for silent stroke) in childhood (P=0.05). Conclusion: Most pediatric hematologists with an SCD expertise recommend cessation of prophylactic penicillin after 5 years of age.
Original language | English (US) |
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Pages (from-to) | 935-939 |
Number of pages | 5 |
Journal | Pediatric Blood and Cancer |
Volume | 60 |
Issue number | 6 |
DOIs | |
State | Published - Jun 2013 |
Keywords
- Invasive pneumococcal disease
- Penicillin prophylaxis
- Sickle cell disease
- Survey
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Hematology
- Oncology