Significant morbidity and mortality has been consistently documented in pediatric sickle cell patients due to overwhelming sepsis from encapsulated organisms, especially S. pneumoniae
All pediatric sickle cell patients presenting with fevers greater than 101.5F (38.6C) should receive antibiotics within 60 minutes of triage.
Historically, and still in many pediatric sickle cell centers, ceftriaxone (75mg/kg/dose) is administered
However, reported cases of deadly intravascular hemolysis in pediatric sickle cell patients whom had recieved multiple doses of ceftriaxone has led to new recommendations for antibiotic coverage to include cefuroxime (200mg/kg/day) or ampicillin/sulbactam (200mg/kg/day)
References
Wang CJ, et al. Quality-of-care indicators for children with sickle cell disease. Pediatrics. 2011;128:484.
Berini JC, et al. Fatal hemolysis induced by Ceftriaxone in a child with sickle cell anemia. 1995;126:813.
