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Master Thesis

Stratégies de prévention et de traitement des épisodes infectieux en médecine générale chez les patients splénectomisés en Aquitaine entre 2013 et 2016

Abstract : Overwhelming Post-Splenectomy Infection (OPSI) is a serious complication of splenectomy. This fulminant form of bacteriemia can lead to death in less than 48 hours. In order to reduce this risk, current guidelines detail preventive measures with immunization towards S.pneumoniae, N.meningitidis, Haemophilus influenza type b and influenza virus, as well as antibiotic prophylaxis and education of the patient. We conducted a multicenter retrospective study including splenectomized patients between 2013 and 2016 in Bordeaux, Bayonne and Pau. General practitioners were questioned about the vaccination coverage of splenectomized patients and the administration of prophylactic antibiotics. They were also questioned about their management of infectious episodes. 103 patients were included. Only 57% of patients were correctly vaccinated against streptococcus pneumoniae, 57% received any type of meningococcal vaccine, 74% haemophilus influenza vaccine, and 59% annual influenza vaccine. Only 23% of patients received all of these vaccinations. Almost 66% received prophylactic antibiotics mainly with penicillin V for at least two years. Half of the patients experienced at least one infectious episode, mainly lung and ENT infections, and influenza, potentially preventable with adequate vaccines. These data are in accordance with those found in the international literature such as in Australia or United Kingdom. It is necessary to improve preventive measures in this peculiar population of severely immunocompromised patients. Remediation strategies could be a better transmission of medical data between healthcare professionals as well as educational measures to keep them up to date in the management of splenectomized patients. On the other hand a better therapeutic education of these patients is paramount.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02507802
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Charlotte Queffelec. Stratégies de prévention et de traitement des épisodes infectieux en médecine générale chez les patients splénectomisés en Aquitaine entre 2013 et 2016. Médecine humaine et pathologie. 2019. ⟨dumas-02507802⟩

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