Thalassemia Faq's

DOC for prophylaxis in patients with thalassemia who have undergone a splenectomy (erythromycin used in patients allergic to penicillin); active against most microorganisms considered to be major pathogens in splenectomized patients (ie, streptococcal, pneumococcal, and some staphylococcal microorganisms) but not penicillinase-producing species. Prophylaxis provided for >3 y after splenectomy.

Dosage:

Adult

250-500 mg PO bid

Pediatric

<5 years: 125 mg/dose PO bid
>5 years: 250 mg/dose PO bid
Streptococcal infections: Administer above doses for >10 d
Prophylaxis: Treat for >3 y after splenectomy

Interactions:

Probenecid may increase effectiveness by decreasing clearance; tetracyclines are bacteriostatic, causing a decrease in the effectiveness of penicillins when administered concurrently.

Contraindications:

Documented hypersensitivity.

Precautions:

Pregnancy

C - Fetal risk revealed in studies in animals but not established or not studied in humans; may use if benefits outweigh risk to fetus

Precautions

Patients with asthma may have hypersensitivity; PO route usually not adequate for treatment of severe infections; treat for minimum of 10 d for streptococcal infections.

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