In which case pneumococcal vaccine is most effective:: (A) When given preoperatively, (B) When given post operatively, (C) Against all strains of bacteria, (D) Against gram negative bacteria
Answer is A. Ans is 'a' ie When given preoperatively "Timing of vaccination generally is accepted as a minimum of 2 weeks before planned elective splenectomy and within 7 to 10 days after unplanned or emergent splenectomy, although data supporting this practice are lacking." -- Schwartz 9/e "Pneumococcal vaccine should be administered to all patients 2 weeks before elective splenectomy. Harrison 17/eIf the spleen is removed in emergency (eg. following trauma), vaccination should be given as soon as possible following surgery.Booster injection of pneumococcal vaccine should be given every 5 to 6 years.Other vaccines advisable in splenectomy pts: vaccines to Neisseria meningitides, Haemophilus influenza type b