{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T12:22:26Z","timestamp":1756902146040,"version":"3.44.0"},"reference-count":13,"publisher":"The Pediatric Pharmacy Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Patients with sickle cell disease (SCD) are at increased risk for invasive pneumococcal disease (IPD) caused by Streptococcus pneumoniae. Immunization and antimicrobial prophylaxis may prevent this complication, and landmark clinical trials support discontinuation of antimicrobial prophylaxis at age 5 years. However, antimicrobial prophylaxis continues in some patients indefinitely. The objective of this study was to evaluate the incidence of culture-positive IPD and other infections in the setting of penicillin prophylaxis in the pediatric SCD population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This was a single-center, retrospective cohort study of patients with SCD who continued antimicrobial prophylaxis with penicillin, compared with those whose antimicrobial prophylaxis was discontinued. Included patients were aged 5 to 18 years during the study period and had no history of IPD or surgical splenectomy. Patient charts were reviewed for demographics, immunizations, penicillin prescription history, and microbiologic culture data.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Antimicrobial prophylaxis continued beyond age 5 years in 65% of patients, a higher percentage of whom had hemoglobin SS or S beta-zero disease. No patients whose antimicrobial prophylaxis was discontinued experienced IPD; 1 patient who continued antimicrobial prophylaxis died of S pneumoniae sepsis. Rates of other infections were comparable between groups (21% in prophylaxis versus 18% in no prophylaxis).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>These results support appropriate de-prescribing of antimicrobial prophylaxis in patients with SCD who are not at high risk for IPD. Further multicenter studies are needed to evaluate consequences of antimicrobial prophylaxis with alternative agents on antibiotic resistance, examine provider rationale for continuation of antimicrobial prophylaxis, and assess quality of life effects (e.g., medication adherence, adverse drug reactions) of antimicrobial prophylaxis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.5863\/1551-6776-28.6.519","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T17:50:50Z","timestamp":1698688250000},"page":"519-523","source":"Crossref","is-referenced-by-count":2,"title":["Penicillin Prophylaxis in Patients With Sickle Cell Disease Beyond Age 5 Years"],"prefix":"10.5863","volume":"28","author":[{"given":"Tyler G.","family":"Eastep","sequence":"first","affiliation":[{"name":"Department of Pharmacy (TGE, RMK, JZ, AM), Children\u2019s Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca M.","family":"Kendsersky","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (TGE, RMK, JZ, AM), Children\u2019s Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Zook","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (TGE, RMK, JZ, AM), Children\u2019s Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Astrela","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Pharmacy (TGE, RMK, JZ, AM), Children\u2019s Hospital of Philadelphia, Philadelphia, PA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","published-online":{"date-parts":[[2023,10,28]]},"reference":[{"issue":"(5)","key":"2023111414184460500_i2331-348X-28-6-519-b1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1542\/pir.33.5.195","article-title":"Sickle cell disease [correction appears in Pediatr Rev. 2012;33(8):375 and Pediatr Rev. 2012;33(8):383]","volume":"33","author":"McCavit","year":"2012","journal-title":"Pediatr Rev"},{"issue":"(1)","key":"2023111414184460500_i2331-348X-28-6-519-b2","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.1016\/j.ijid.2009.03.010","article-title":"Infection in sickle cell disease: a review","volume":"14","author":"Booth","year":"2010","journal-title":"Int J Infect Dis"},{"issue":"(12)","key":"2023111414184460500_i2331-348X-28-6-519-b3","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1097\/INF.0b013e3182a11808","article-title":"Invasive pneumococcal disease among children with and without sickle cell disease in the United States, 1998 to 2009","volume":"32","author":"Payne","year":"2013","journal-title":"Pediatr Infect Dis J"},{"issue":"(suppl 1)","key":"2023111414184460500_i2331-348X-28-6-519-b4","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1182\/blood-2021-154474","article-title":"Population-based surveillance of pneumococcal infections in children with sickle cell disease before and after prevnar 7\u00ae and prevnar 13\u00ae licensure: implications for expanded vaccination","volume":"138","author":"Adamkiewicz","year":"2021","journal-title":"Blood"},{"issue":"(3)","key":"2023111414184460500_i2331-348X-28-6-519-b5","doi-asserted-by":"crossref","first-page":"e2020049775","DOI":"10.1542\/peds.2020-049775","article-title":". Recommended childhood and adolescent immunization schedule: United States, 2021","volume":"147","author":"Committee on Infectious Diseases","year":"2021","journal-title":". Pediatrics"},{"issue":"(25)","key":"2023111414184460500_i2331-348X-28-6-519-b6","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1056\/NEJM198606193142501","article-title":"Prophylaxis with oral penicillin in children with sickle cell anemia: arandomized trial","volume":"314","author":"Gaston","year":"1986","journal-title":"N Engl J Med"},{"issue":"(5)","key":"2023111414184460500_i2331-348X-28-6-519-b7","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S0022-3476(95)70154-0","article-title":"Discontinuing penicillin prophylaxis in children with sickle cell anemia: Prophylactic Penicillin Study II","volume":"127","author":"Falletta","year":"1995","journal-title":"J Pediatr"},{"issue":"(10)","key":"2023111414184460500_i2331-348X-28-6-519-b8","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1001\/jama.2014.10517","article-title":"Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members [correction appears in JAMA. 2014;312(18):1932 and JAMA. 2015;313(7):729]","volume":"312","author":"Yawn","year":"2014","journal-title":". JAMA"},{"issue":"(3)","key":"2023111414184460500_i2331-348X-28-6-519-b9","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1111\/j.1365-2141.2011.08843.x","article-title":"Review of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen: prepared on behalf of the British Committee for Standards in Haematology by a working party of the Haemato-Oncology task force","volume":"155","author":"Davies","year":"2011","journal-title":"Br J Haematol"},{"issue":"(6)","key":"2023111414184460500_i2331-348X-28-6-519-b10","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1002\/pbc.24395","article-title":"Prophylactic penicillin after 5 years of age in patients with sickle cell disease: a survey of sickle cell disease experts","volume":"60","author":"McCavit","year":"2013","journal-title":"Pediatr Blood Cancer"},{"journal-title":"International Classification of Diseases","year":"1978","author":"World Health Organization.","key":"2023111414184460500_i2331-348X-28-6-519-b11"},{"journal-title":"International Classification of Diseases","year":"2010","author":"World Health Organization","key":"2023111414184460500_i2331-348X-28-6-519-b12"},{"issue":"(9)","key":"2023111414184460500_i2331-348X-28-6-519-b13","first-page":"CD006110","volume":"9","author":"Mart\u00ed-Carvajal","year":"2019","journal-title":"Cochrane Database Syst Rev"}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/meridian.allenpress.com\/jppt\/article-pdf\/28\/6\/519\/3288872\/i2331-348x-28-6-519.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/meridian.allenpress.com\/jppt\/article-pdf\/28\/6\/519\/3288872\/i2331-348x-28-6-519.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T18:37:52Z","timestamp":1738780672000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/28\/6\/article-p519.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,1]]},"references-count":13,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,10,28]]},"published-print":{"date-parts":[[2023,10,1]]}},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-28.6.519","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"type":"electronic","value":"2331-348X"},{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2023,10,1]]}}}