For prophylaxis in children with sickle cell disease under 5 years of age, which medication is advised?

In the context of children with sickle cell disease who are under 5 years of age, the recommended prophylactic medication is penicillin. This is essential because children with sickle cell disease are at increased risk for infections, particularly from encapsulated organisms such as Streptococcus pneumoniae and Haemophilus influenzae.

Prophylactic penicillin helps prevent such infections by providing a continuous antimicrobial effect. The standard practice is to start penicillin prophylaxis as early as 2 months of age and continue it until at least 5 years of age, ensuring adequate protection during a critical period when these children are especially vulnerable. The regimen typically involves penicillin taken twice daily.

While other antibiotics may be used in various clinical circumstances, such as azithromycin for different types of infections or ceftriaxone for established infections, they do not serve the same prophylactic purpose for children with sickle cell disease as penicillin does. Thus, penicillin is specifically highlighted for its effectiveness in reducing the incidence of severe infections in this population.