On 2014 Oct 04, Quentin Hill commented:

In the section on guidelines, the authors have stated that the current British Committee for Standards in Haematology guidelines Davies JM, 2011 recommend lifelong penicillin prophylaxis for all persons with surgical asplenia. Although this was true in previous guidelines Working Party of the British Committee for Standards in Haematology Clinical Haematology Task Force., 1996, Davies et al recommend a risk adapted approach to antibiotic prophylaxis. They recommend antibiotic prophylaxis "at least" in the immediate post-operative period following splenectomy for trauma. Otherwise, long term prophylaxis is recommended for those considered to be high risk of pneumococcal infection: age <16 years or >50 years, inadequate serological response to pneumococcal vaccination, previous invasive pneumococcal disease and splenectomy for underlying haematological malignancy.

Additionally, the authors do not discuss the meningitis serogroup B vaccine (MenB). A MenB vaccine was licensed by the European Medicines Agency in January 2013. Although not yet FDA licensed, it has been used to control several outbreaks in the United States http://www.cdc.gov/meningococcal/outbreaks/vaccine-serogroupb.html. In England, over 80% of Neisseria meningitidis cases are due to capsular group B strains and it has been recommended in England for children and adults with asplenia, splenic dysfunction and complement disorders https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book.

On 2014 Oct 04, Quentin Hill commented:

In the section on guidelines, the authors have stated that the current British Committee for Standards in Haematology guidelines Davies JM, 2011 recommend lifelong penicillin prophylaxis for all persons with surgical asplenia. Although this was true in previous guidelines Working Party of the British Committee for Standards in Haematology Clinical Haematology Task Force., 1996, Davies et al recommend a risk adapted approach to antibiotic prophylaxis. They recommend antibiotic prophylaxis "at least" in the immediate post-operative period following splenectomy for trauma. Otherwise, long term prophylaxis is recommended for those considered to be high risk of pneumococcal infection: age <16 years or >50 years, inadequate serological response to pneumococcal vaccination, previous invasive pneumococcal disease and splenectomy for underlying haematological malignancy.

Additionally, the authors do not discuss the meningitis serogroup B vaccine (MenB). A MenB vaccine was licensed by the European Medicines Agency in January 2013. Although not yet FDA licensed, it has been used to control several outbreaks in the United States http://www.cdc.gov/meningococcal/outbreaks/vaccine-serogroupb.html. In England, over 80% of Neisseria meningitidis cases are due to capsular group B strains and it has been recommended in England for children and adults with asplenia, splenic dysfunction and complement disorders https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book.