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A secondary complication is infection, which can be bacterial, fungal or viral. Universal newborn screening, routine use of penicillin prophylaxis, availability of conjugated vaccines against <jats:italic>S<\/jats:italic>.\u00a0<jats:italic>pneumoniae<\/jats:italic> and comprehensive care programmes instituted during the past few decades in industrialized countries have dramatically reduced childhood mortality and improved life expectancy. Yet patients with <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content> remain at increased risk of infection. Unfortunately, the treatment of most bacterial infections that are common in <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content> is not based on the results of randomized controlled clinical trials. In their absence, treatment decisions are based on consensus guidelines, clinical experience or adapting treatment applied in other diseases. This leads to wide variation in treatment among institutions and even between treating physicians in a single institution. Prevention of infection, when possible, is most important and we focus on prevention through targeted prophylaxis and vaccination. We will share our management strategies for managing the more common infections in <jats:styled-content style=\"fixed-case\">SCD<\/jats:styled-content> and provide the rationale for our recommendations.<\/jats:p>","DOI":"10.1111\/bjh.13526","type":"journal-article","created":{"date-parts":[[2015,5,28]],"date-time":"2015-05-28T13:08:19Z","timestamp":1432818499000},"page":"757-767","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["How we prevent and manage infection in sickle cell disease"],"prefix":"10.1111","volume":"170","author":[{"given":"Amy","family":"Sobota","sequence":"first","affiliation":[{"name":"Boston University School of Medicine Boston MA USA"},{"name":"Department of Pediatrics Boston Medical Center Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishakha","family":"Sabharwal","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine Boston MA 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