Are the Splenectomy Guidelines being followed at SUHT ? Jessica Burnup, Pharmacist, Southampton University Hospitals Tru

1. Are the Splenectomy Guidelines being followed at SUHT ?Jessica Burnup, Pharmacist, Southampton University Hospitals Trust Background The main function of the spleen is to filter the blood by phagocytosis and initiate immune responses Splenectomy patients are at an increased risk of serious infection especially from S.Pneumoniae, H. influenzae and N. menigitides Patients should receive the Pneumovax II and Menitorix vaccines 2 weeks pre or post op Patients should be discharged with life long prophylactic antibiotics and a course of emergency antibiotics There was a concern that this was not happening at SUHT Patients are sent home with a ‘splenectomy’ letter, to be given to their GP Aim To determine if 100% of patients received the required antibiotics To determine if patients were discharged with prophylactic and emergency antibiotics. Method All patients who had a splenectomy in the past year were identified Their hospital notes and/or GPs were contacted to see when the vaccines were given and what they were discharged with Results -100% received prophylactic antibiotics -Only 14% received emergency antibiotics -2 patients only received the Pneumovax II and not the Menitorix Recommendations 1. Re-word the current splenectomy letter that is sent out to patients after their surgery 2. Produce a letter that can be used in the pre-assessment clinic. 3. Use e-discharge system to send letters directly to the GPs as well as via patients 4. Re-education on the guidelines and the importance of the emergency course of antibiotics. 5. Write a summary of the splenectomy guidelines in the monthly PCT newsletter. Reference: Davis J, Barnes R, Milligan D. Update of Guidelines for the Prevention and Treatment of Infection in Patients with an Absent or Dysfunctional Spleen. Journal of the Royal College of Physicians of London 2002; 2 (5): 440-443