Individuals without a functional spleen are at risk of overwhelming bacterial sepsis with associated high mortality.
Organisms of particular concern are encapsulated organisms such as Haemophilus influenza, Neisseria meningitidis, and Streptococcus pneumoniae.
If vaccination is provided less than 14 days before or after splenectomy there may be reduced efficacy and a repeat primary series 8 weeks later should be considered.
Primary prophylaxis with daily antibiotic therapy is not recommended in adult asplenic patients.
Asplenic individuals should be educated about the risk of sepsis and should be provided a standing prescription for either Amoxicillin‐clavulanic acid or Levofloxacin to be initiated at the onset of fever followed by immediate presentation to medical attention. An instructional letter may be provided for patients to provide to healthcare providers with recommendations for their management. Patients should wear a medical alert bracelet stating their asplenic status.
Elective Splenectomy AND Able to Wait 2 weeks
Emergent Splenectomy OR Cannot wait 2 weeks