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The Pediatric Forum
March 1, 2010

Adherence to Prophylactic Antibiotic Guidelines Among Medicaid Infants With Sickle Cell Disease

Author Affiliations

Author Affiliations: Departments of Pediatrics (Drs Warren and Cooper), Biostatistics (Dr Arbogast and Ms Kaltenbach), and Preventive Medicine (Drs Arbogast and Ray and Ms Dudley), Vanderbilt University, Nashville, Tennessee; and the Department of Hematology, St Jude Children's Research Hospital, Memphis, Tennessee (Dr Wang).

Arch Pediatr Adolesc Med. 2010;164(3):298-299. doi:10.1001/archpediatrics.2009.286

Infants with sickle cell disease have as much as a 100-fold increased rate of pneumococcal infection compared with the general population.1 Penicillin prophylaxis has been shown to reduce the risk of pneumococcal sepsis by 84%.2 Thus, sickle cell management guidelines include twice daily penicillin doses for infants and young children.3 While studies have described low rates of adherence to prophylactic antibiotic guidelines in older children, little is known about the initiation of prophylactic antibiotics in early infancy, a period of great vulnerability.4 We describe adherence to guidelines for initiation of prophylactic antibiotics in a cohort of Medicaid infants with sickle cell disease in Tennessee and examine risk factors for nonadherence.

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