Which infection-prevention measures are recommended for patients with sickle cell anemia?

• A. Vaccinations only
• B. Daily penicillin until age 5
• C. Vaccinations and daily penicillin until age 5
• D. Vaccinations, daily penicillin, and asbestos precautions

Answer: (C)

In sickle cell disease, the spleen often loses function, making children especially vulnerable to serious infections from encapsulated bacteria like pneumococcus. To prevent these infections, the recommended plan combines vaccines and daily antibiotic prophylaxis during early childhood. Vaccinations protect against pneumococcus, Haemophilus influenzae type b, meningococcus, and influenza, while daily penicillin during early childhood specifically reduces the risk of pneumococcal bacteremia. The standard duration for penicillin prophylaxis is until age five, after which it is usually stopped if there are no other risk factors. Asbestos precautions have no role in this infection-prevention strategy. Therefore, the best approach is vaccines plus daily penicillin until age five.