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Penicillin prophylaxis in these patients significantly reduces the risk of septicemia; however, continuation of prophylaxis beyond 5 years of age is controversial, since the risk of developing septicemia is reduced after this age and prolonged prophylaxis may lead to emergence of penicillin resistance. Although reports of penicillin\u2010resistant pneumococci in patients receiving penicillin prophylaxis are conflicting, the prevalence of these organisms in the general population in North America increased from 5% in 1989 to more than 35% in 1997. Discontinuation of prophylaxis after age 5 years may be recommended because of lack of benefit, difficulty maintaining compliance, reduced risk of developing pneumococcal bacteremia after that age, and increase in prevalence of penicillin\u2010resistant pneumococci worldwide.<\/jats:p>","DOI":"10.1592\/phco.20.1.110.34660","type":"journal-article","created":{"date-parts":[[2004,6,10]],"date-time":"2004-06-10T10:27:54Z","timestamp":1086863274000},"page":"110-117","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Duration of Penicillin Prophylaxis in Sickle Cell Anemia: Issues and Controversies"],"prefix":"10.1002","volume":"20","author":[{"given":"Vinita B.","family":"Pai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milap 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