Prevention of infection in asplenic adult patients by general practitioners in France between 2013 and 2016

Abstract

Background Guidelines that detail preventive measures against Streptococcus pneumoniae , Neisseria meningitidis , Haemophilus influenzae type b, and influenza are published annually in France to decrease the risk of severe infections in immunocompromised patients. We aimed at describing adherence to these guidelines by GPs in the management of their asplenic patients in France between 2013 and 2016. Method We conducted a multicenter retrospective study between January 2013 and December 2016 in three French hospitals: asplenic adults were identified and their GPs were questioned. A descriptive analysis was performed to identify the immunization coverage, type and length of antibiotic prophylaxis, number of infectious episodes, and education of patients. Results 103 patients were finally included in this study: only 57% were adequately vaccinated against Streptococcus pneumoniae or Neisseria meningitidis , 74% against Haemophilus influenzae type b, and 59% against influenza. Only 24% of patients received a combination of all four vaccinations. Two-thirds of patients received prophylactic antibiotics for at least 2 years. Overall, this study found that 50% of splenectomized patients experienced at least one pulmonary or otorhinolaryngological infection, or contracted influenza. Conclusions These data match those reported in other countries, including Australia and the United Kingdom, meaning a still insufficient coverage of preventive measures in asplenic patients. Improved medical data sharing strategies between healthcare professionals, along with educational measures to keep patients and physicians up to date in the prevention of infections after splenectomy would improve health outcomes of asplenic patients.

Vaccine coverage for recommended vaccines among splenectomised patients in Apulia, South Italy: a retrospective cohort study

“…Currently, the lack of recommendations by GPs and the absence of a clear communication circuit between GPs and branch specialists are considered the main obstacles to these patients’ access to immunisation. A 2020 French study 21 reported low VCs in a sample of 103 patients splenectomised from 2013 to 2016, concluding that the role of GPs is central in the long-term monitoring and management of infections in this population of patients, in collaboration with all healthcare professionals.…”

Prevention and treatment of infection in patients with an absent or hypofunctional spleen: A British Society for Haematology guideline

“…In France, national guidelines are published annually. Adherence by general practitioners was assessed in three hospitals and found to be insufficient 42 . Pneumococcal and meningococcal vaccine uptake was only 57%, with 74% uptake against Hib and 59% against influenza, with only 24% receiving all four vaccines.…”