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Penicillin prophylaxis for patients with hyper-reactive malarial splenomegaly

By Rebecca Cook | 15 Aug, 2017

Dear all,

We are starting to enroll patients with hyper-reactive malarial splenomegaly (also known as tropical splenomegaly) in our NCD clinic in Liberia. The evidence is fairly clear in terms of the role of malaria prophylaxis in this population but I have found much less about whether they should be placed on penicillin prophylaxis (either Pen VK or monthly benzathine PCN) for functional asplenia like we do for patients with sickle cell disease.
I'd be eager to here other's practice and experience. Do you routinely provide penicillin prophylaxis in this population? If so for how long? What are your criteria for initiating and something prophylaxis?

Kind regards,
Rebecca

Replies

 

NIRMAL GHIMIRE Replied at 9:47 AM, 16 Aug 2017

It doesn't seems logical to put patients on penicillin prophylaxis as the
pathology occurring in this syndrome is different than in the case of
other prophylaxis requiring diseases. .till date no guidelines are strong
in favour for
Penicillin use. .and not in our part of the world like Nepal, India and
south Asia where this condition
are very common.

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