Managing patients with an absent or dysfunctional spleen. Under half of doctors know that antibiotic prophylaxis should be life long.

EDITOR,—Despite several articles in the medical press over the past two years, including communications to all doctors from the chief medical officer, we were dismayed to note that several elderly patients admitted to our wards who had had splenectomies years previously had not been given advice on prophylaxis against infection or relevant immunisation. Deodhar et al found that in 184 patients who had had a splenectomy during a 12 year period 58% had not received advice or …