Decreased Incidence of Respiratory Infections in Children After Vaccination with Ten-valent Pneumococcal Vaccine

Sigurdsson, Samuel; Kristinsson, Karl G.; Erlendsdóttir, Helga; Hrafnkelsson, Birgir; Haraldsson, Ásgeir

doi:10.1097/inf.0000000000000899

Cited by 38 publications

(25 citation statements)

References 39 publications

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“…While it should be noted that the introduction of the pneumococcal vaccine in the general vaccination program in Sweden in 2008–2009 may also have played a part in the reduction of AOM in the age group <1 year. [29, 30], taken together these findings suggest an increased adherence to diagnosis and treatment guidelines.…”

Section: Discussionmentioning

confidence: 82%

Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records

et al. 2016

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BackgroundSwedish studies on antibiotic use in primary care have been based on one-week registrations of infections. In order to study adherence to guidelines, analyses based on large databases that provide information on diagnosis linked prescriptions, are needed. This study describes trends in management of infections in Swedish primary care particularly with regards to antibiotic prescribing and adherence to national guidelines.MethodsA descriptive study of Sweden’s largest database regarding diagnosis linked antibiotic prescription data, the Primary care Record of Infections in Sweden (PRIS), for the years 2008, 2010 and 2013.ResultsAlthough the consultation rate for all infections remained around 30% each year, antibiotic prescribing rates decreased significantly over the years from 53.7% in 2008, to 45.5% in 2010, to 38.6% in 2013 (p = .032). The antibiotic prescribing rate for respiratory tract infections (RTIs) decreased from 40.5% in 2008 to 24.9% in 2013 while those for urinary tract infections and skin and soft tissue infections were unchanged. For most RTI diagnoses there was a decrease in prescription rate from 2008 to 2013, particularly for the age group 0–6 years. Phenoxymethylpenicillin (PcV) was the antibiotic most often prescribed, followed by tetracycline. Tonsillitis and acute otitis media were the two RTI diagnoses with the highest number of prescriptions per 1000 patient years (PY). For these diagnoses an increase in adherence to national guidelines was seen, with regards to treatment frequency, choice of antibiotics and use of rapid antigen detection test. The frequency in antibiotic prescribing varied greatly between different Primary Healthcare Centres (PHCCs).ConclusionFalling numbers of consultations and decreased antibiotic prescription rates for RTIs have reduced the antibiotic use in Swedish primary care substantially. Overprescribing of antibiotics could still be suspected due to large variability in prescribing frequency, especially for acute bronchitis and sinusitis. Continuous evaluation of diagnosis linked prescribing data and feedback to doctors is essential in order to achieve a more prudent antibiotic use.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-2018-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 82%

Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records

et al. 2016

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“…In a nested study in Finland, reductions in vaccine-type carriage, as well as a trend toward a reduction in acute otitis media, were observed with both schedules [39]. Effectiveness of PCVs administered as a 2 + 1 schedule has also been demonstrated in post-marketing studies [40][41][42]. The clinical relevance of the observed differences in antibody kinetics after 2 + 1 or 3 + 0 vaccination is however unknown as there are no clinical outcome data from randomized trials that directly compare a 2 + 1 and 3 + 0 schedule with marketed higher valent PCVs in developing countries.…”

Section: Discussionmentioning

confidence: 87%

Immunization with 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) according to different schedules in infants in South Africa: a phase III trial

Madhi

Koen

Jose

et al. 2017

Expert Review of Vaccines

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Background: Limited clinical data exists to assess differences between various infant pneumococcal conjugate vaccine schedules. In this trial, we evaluated immunogenicity of the 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) administered using 3 different immunization schedules in HIV unexposed-uninfected infants in South Africa. Methods: In this phase III, open, single-center, controlled study (clinicaltrials.gov: NCT00829010), 300 infants were randomized (1:1:1) to 1 of 3 PHiD-CV schedules: 3-dose priming and booster (3 + 1); 3-dose priming without booster (3 + 0); or 2-dose priming and booster (2 + 1). The booster was administered at 9-10 months of age. immune responses were assessed up to 21 months after primary vaccination. Results: Post-priming antibody levels tended to be lower in the 2 + 1 group. At 6 months post-priming, antibody concentrations and opsonophagocytic activity titers were within similar ranges after 2-or 3-dose priming. Robust increases were observed pre-to post-booster in the 3 + 1 and 2 + 1 groups. Conclusions: PHiD-CV was immunogenic when administered in different schedules. Post-booster responses suggest effective immunological priming with both 2-and 3-dose primary series and support administration of the booster dose at 9-10 months of age. ARTICLE HISTORY

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“…Interestingly, the all-cause AOM is estimated to be reduced by only 0–7% in many regions of the world [91••, 101, 102], despite a reduction in pneumococcal OM, which suggest both that a concomitant increase in serotype replacement by non-vaccine serotypes is taking place to some extent and that AOM caused by other organisms is increasing. However, with the introduction of PCV13, some parts of the world with high levels of pneumococcal colonization and disease have seen a 24–68% reduction in all-cause AOM [16••, 103, 104], suggesting an increased efficacy of the vaccine in areas with the highest disease burden. As not enough time has passed to make long-term predictions about the efficacy of these vaccines, continued monitoring of the nasopharyngeal microflora and causes of AOM will be important in the future in various parts of the world.…”

Section: Vaccinesmentioning

confidence: 99%

Streptococcus pneumoniae Otitis Media Pathogenesis and How It Informs Our Understanding of Vaccine Strategies

Bergenfelz

Håkansson

2017

Curr Otorhinolaryngol Rep

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Purpose of ReviewThis study aimed to review the literature regarding the mechanisms of transition from asymptomatic colonization to induction of otitis media and how the insight into the pathogenesis of otitis media has the potential to help design future otitis media-directed vaccines.Recent FindingsRespiratory viruses have long been shown to predispose individuals to bacterial respiratory infections, such as otitis media. Recent information suggests that Streptococcus pneumoniae, which colonize the nasopharynx asymptomatically, can sense potentially “threatening” changes in the nasopharyngeal environment caused by virus infection by upregulating specific sets of genes involved in biofilm release, dissemination from the nasopharynx to other sites, and protection against the host immune system. Furthermore, an understanding of the transcriptional and proteomic changes occurring in bacteria during transition to infection has led to identification of novel vaccine targets that are disease-specific and will not affect asymptomatic colonization. This approach will avoid major changes in the delicate balance of microorganisms in the respiratory tract microbiome due to elimination of S. pneumoniae.SummaryOur recent findings are reviewed in the context of the current literature on the epidemiology and pathogenesis of otitis media. We also discuss how other otopathogens, such as Haemophilus influenzae and Moraxella catarrhalis, as well as the normal respiratory microbiome, can modulate the ability of pneumococci to cause infection. Furthermore, the unsatisfactory protection offered by the pneumococcal conjugate vaccines is highlighted and we review potential future strategies emerging to confer a more specific protection against otitis media.

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Decreased Incidence of Respiratory Infections in Children After Vaccination with Ten-valent Pneumococcal Vaccine

Cited by 38 publications

References 39 publications

Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records

Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records

Immunization with 10-valent pneumococcal non-typeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) according to different schedules in infants in South Africa: a phase III trial

Streptococcus pneumoniae Otitis Media Pathogenesis and How It Informs Our Understanding of Vaccine Strategies

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