When is antibiotic therapy indicated in the treatment of sickle cell disease (SCD), and which antibiotics are used?

Updated: May 12, 2021
  • Author: Joseph E Maakaron, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Antibiotics are indicated when an infection is suspected, when body temperature is higher than 38° C, or when a patient has localized bone tenderness. The 2003 BCSH guidelines also recommend the use of broad-spectrum antibiotics in the patient who is systemically ill or has chest involvement. [46] Fever in children is strongly suggestive of infection. Signs of infection have proved to be more accurate in children than in adults.

Recommended parenteral antibiotics include cephalosporins (eg, ceftriaxone, cefuroxime) and macrolides for acute chest syndrome. If the patient is discharged home, oral antibiotics (eg, amoxicillin-clavulanic acid, clarithromycin, cefixime) are useful in selected cases. If the patient has localized bone tenderness, the antibiotic selected should provide coverage for Salmonella typhimurium and Staphylococcus aureus.


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