Table 1.

Prophylaxis of Complications from Sickle Cell Disease

Complication	ProphylacticTherapy
Streptococcus pneumoniae sepsis	Newborns to 3 years: Penicillin VK, 125 mg orally twice daily 3 to 5 years: Penicillin VK, 250 mg orally twice daily 2 years: 23-valent Streptococcus pneumoniae polysaccharide vaccine (PPV23)
Bone marrow aplasia and megaloblastic erythropoiesis	1 mg folic acid daily
Stroke	Exchange transfusions
Pain episodes	Hydroxyurea Initiation of treatment: 10–15 mg/kg/day single daily dose for six to eight weeks Monitor: complete blood count every two weeks percent fetal hemoglobin every six to eight weeks serum chemistries every two to four weeks