Prevention of pneumococcal infection in children with homozygous sickle cell disease.

Abstract

The efficacy of prophylactic penicillin and of 14 valent pneumococcal vaccine in preventing pneumococcal infection in homozygous sickle cell (SS) disease was investigated in 242 children aged 6 months to 3 years at entry. In the first five years of the trial there were 11 pneumococcal infections in the pneumococcal vaccine treated group, 10 by serotypes present in the vaccine. Type 23 accounted for five of these, and there was evidence of higher infection rates in those given the vaccine before age 1. No pneumococcal isolations occurred in the penicillin group while receiving penicillin, although four isolations occurred within one year of stopping penicillin.Probably the most effective prophylaxis against pneumococcal infection requires penicillin beyond the age of 3. The age at which pneumococcal vaccine should be given must await further data on antibody response and clinical efficacy in these patients.

Polysaccharide encapsulated bacterial infection in sickle cell anemia: A thirty year epidemiologic experience

“…The widespread use of prophylactic penicillin and the ready availability of antibiotics in the home may have precluded culture and latex slide agglutination documentation of some incidence of bacterial infection during the last few years. We find little data to support the use of prophylactic penicillin (or other antibiotic) regimens in previously untreated but immunized American SS patients greater than 3 years of age who have ported that children over 3 years of age had pneumococcal infections upon stopping penicillin prophylaxis [24]. This issue is currently under investigation in Phase I1 American trials.…”

Evolution of sickle cell disease from a life‐threatening disease of children to a chronic disease of adults: The last 40 years

“…A single center trial [33], followed by a multicenter, randomized clinical trial unequivocally demonstrated the benefit of penicillin prophylaxis for preventing SCD related pneumococcal sepsis. In the "PRophylaxis with Oral Penicillin in children with Sickle cell anemia" (PROPS) trial, children with SCA younger than 3 years were randomly assigned to receive either 125 mg of penicillin V (105 children) or placebo (110 children) twice daily [34].…”

Summary of ‘Prophylactic antibiotics for preventing pneumococcal infection in children with sickle cell disease’

“…The results of the trial by John (2) show that prophylactic penicillin is feasible in resource-limited countries. The cost is low (approximately US$1 per month) and monthly injections may aid compliance, providing individuals attend clinics regularly.…”