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Pneumonia (pneumococcal) vaccines for children and adults with bronchiectasis

In many countries pneumonia vaccination (for the protection against infection of the bacteria pneumococcus), is part of the immunisation schedule for infants as well as for people with bronchiectasis. In this review, our search for randomised control trials that examined the effectiveness of pneumococcal vaccines for people with bronchiectasis revealed one randomised and one quasi‐controlled trial. We conclude that, albeit the limitations of the review, adults and children (when age appropriate) with bronchiectasis should be vaccinated with the 23‐valent polysaccharide pneumococcal vaccine as suggested in many national guidelines. Due to absence of data on how often the vaccine should be given, we recommend that national guidelines be followed until further evidence is available.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Pneumococcal vaccines for children and adults with cystic fibrosis

Cystic fibrosis is an inherited disease which causes mucus in the lungs to be more sticky than normal, leading to frequent lung infections and lung damage. Pneumococcus is a type of bacteria that can cause infection throughout the body, including in the urine, blood stream, fluid around the brain and in the lungs. These infections can be very serious and may lead to severe illness and death. There are two types of vaccine that can be used to help protect people against some forms of pneumococcus bacteria. One vaccine is used in children under two years of age and the other is used in older children and adults. This review aimed to find trials that compared giving the vaccine against no vaccine or an inactive (placebo) form to assess how useful vaccines against pneumococcus bacteria could be in reducing serious illness and death in people with cystic fibrosis. No trials were identified that assessed these vaccines in people with cystic fibrosis. The evidence to support the routine use of vaccines against pneumococcal infection is not strong; however, many countries are now recommending all children have the vaccine as part of their childhood immunisation programmes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Pneumococcal vaccines for sickle cell disease

People with sickle cell disease are particularly prone to pneumococcal infection, which may be fatal. Children aged up to 23 months are at high risk, but usual polysaccharide pneumococcal vaccines may not work in this age group. New conjugate pneumococcal vaccines may help to reduce the rate of infection in people with sickle cell disease of all ages. We searched for trials which compared a polysaccharide or conjugate pneumococcal vaccine schedule with a different schedule or no vaccination in people with sickle cell disease. The review includes five trials with a total of 547 participants. One trial showed that the polysaccharide vaccine did not reduce the risk of infection very much in children younger than three years old, but it was linked with only minor adverse events. Three trials of conjugate vaccines showed increased antibody responses compared to control groups in people of all ages, although clinical outcomes were not measured in these trials. This review did not show if the vaccines prevent infection or decrease death rates. We recommend that conjugate pneumococcal vaccines are used in people with sickle cell disease. Randomised trials will be needed to determine the best vaccination schedule when further, potentially more effective vaccines become available. Such trials should measure clinical outcomes of effectiveness.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Injectable vaccines for preventing pneumonia in people with chronic obstructive pulmonary disease (COPD)

There is evidence that vaccines can protect healthy persons against invasive disease (bacteraemia, meningitis) and some evidence for prevention of community acquired pneumonia but little is known about the effectiveness of the vaccine in persons with chronic obstructive pulmonary disease (COPD). The results from seven randomised controlled trials involving 1709 people included in this review suggest that pneumococcal vaccination may provide some protection against disease caused by the bacteria but this needs to be confirmed by further studies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Pneumonia (pneumococcal) vaccine for children and adults with asthma

Pneumonia is a serious illness for people who have asthma and pneumococcal vaccine has been studied to see if it reduces illness or death in those people. A thorough search for randomised controlled trials of pneumococcal vaccine in asthma has found only one small study in children which was not of high quality. This showed a reduction in the rate of asthma attacks from ten per year to seven per year. Randomised trials to test pneumococcal vaccine in asthmatic children and adults are needed to assess how beneficial it is for asthmatics to receive this vaccination.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Pneumococcal vaccination during pregnancy for preventing infant infection

There is not enough evidence to assess whether using pneumococcal vaccination during pregnancy can prevent infant infections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Vaccination for preventing pneumococcal infection in adults

Streptococcus pneumoniae (S. pneumoniae) is responsible for a considerable burden of illness and death in adults worldwide, usually from pneumonia and less often from invasive pneumococcal disease. Vaccination (using pneumococcal polysaccharide vaccines) might reduce such illness and death. This updated review included 18 randomised controlled trials involving 64,901 participants and seven non‐randomised controlled trials involving 62,294 participants (the latter contributing outcomes for culture‐confirmed invasive pneumococcal disease only).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Vaccines against overwhelming blood infection due to pneumococcus bacteria and lung infection (pneumonia) among children less than two years of age

Pneumococcus is one of the major causes of overwhelming blood infection and lung infection (pneumonia) among young children. Pneumococci resistant to antibiotics are now being found in great numbers worldwide which may reduce the effectiveness of recommended antibiotic treatment. Preventive measures like vaccination are needed. This review found two trials from the US, two from Africa, one from the Philippines, and another from Finland that involved 113,044 children less than two years of age. In these studies, PCV was able to prevent overwhelming pneumococcal blood infection and pneumonia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Vaccination against a bacterium called pneumococcus for preventing middle ear infection

We reviewed the evidence about the effect of vaccination against pneumococcus (a type of bacterium) on preventing middle ear infections in children.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Regular antibiotics for preventing pneumococcal infection in young children with sickle cell disease

People with sickle cell disease (SCD) are especially prone to respiratory infections and blood poisoning. These infections are often caused by pneumococcal bacteria. Infections occur partly due to the spleen not working correctly, but also because damaged tissue and bone resulting from SCD can harbour bacteria. The highest risk of infection occurs in children under three years old, but the usual pneumococcal vaccines are of limited use in these patients. Therefore regular antibiotics are needed to prevent infection. As risk of infection decreases with age, there might be a time when preventative antibiotic treatment can be halted. Three trials with over 800 children are included in the review. All three trials showed a reduced rate of infection in children with sickle cell disease receiving penicillin preventatively. Two trials looked at whether treatment was effective. The third trial followed on from one of the early trials and looked at when it was safe to stop treatment. Adverse drug effects were rare and minor. However, there were problems with children keeping to the treatment schedule and with the development of antibiotic resistance. We conclude that penicillin given preventatively reduces the rate of pneumococcal infections in children with sickle cell disease under five years old. The risk of infection in older children is lower, and the follow‐on trial did not show a significant increase in risk when regular penicillin was halted at five years old. Further research should look at how common and how clinically important resistant bacteria are.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Vaccines for preventing seasonal influenza and its complications in people aged 65 or older

Influenza vaccination of elderly individuals is recommended worldwide as people aged 65 and older are at a higher risk of complications, hospitalisations and deaths from influenza. This review looked at evidence from experimental and non‐experimental studies carried out over 40 years of influenza vaccination. We included 75 studies. These were grouped first according to study design and then the setting (community or long‐term care facilities). The results are mostly based on non‐experimental (observational) studies, which are at greater risk of bias, as not many good quality trials were available. Trivalent inactivated vaccines are the most commonly used influenza vaccines. Due to the poor quality of the available evidence, any conclusions regarding the effects of influenza vaccines for people aged 65 years or older cannot be drawn. The public health safety profile of the vaccines appears to be acceptable.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Vaccines for preventing herpes zoster in older adults

The virus responsible for chickenpox, varicella zoster virus (VZV), can remain dormant inside nerve cells. Years later, when a person's immunity declines, for example because of aging, the virus may reactivate and travel through the nerve to the skin surface, producing clusters of blisters distributed along the path of the affected nerve, a condition called herpes zoster or shingles. Itching, numbness, tingling or localised pain precede the appearance of skin lesions. The virus causes inflammation of sensory nerves and can cause severe pain which impacts patients' quality of life. The annual incidence of herpes zoster is currently 5.22 episodes per 1000 older adults. This incidence is increasing, in part due to longer lifespan.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Acute middle ear infections (acute otitis media): Middle ear infections: Prevention

Parents might wonder what they can do to help prevent painful middle ear infections, especially if their children have them again and again. There are some things that might be able to lower the risk of middle ear infections somewhat. But it is often not possible to completely prevent them.Children’s immune systems are still maturing and it will take years until they are better at fighting off disease. So colds and middle ear infections are a normal part of a child's development. There is a lack of scientific evidence for the benefit of many things recommended to prevent middle ear infections. If a child has a middle ear infection, it is important to relieve symptoms using an appropriate treatment and to watch for possible complications.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 7, 2013

No strong evidence for any interventions for preventing infection in nephrotic syndrome

Patients with nephrotic syndrome, particularly children, are susceptible to infections. Infections can cause frequent relapses of illness, poor response to therapies (e.g. steroids) and severe infections occasionally lead to death. Oral antibiotics, pneumococcal vaccination, some immunomodulators and Chinese medicinal herbs have been used/recommended for reducing the risk of infection. No studies on antibiotics, pneumococcal vaccination and any other non‐drug prophylaxis were identified. This review found that intravenous immunoglobulin (IVIG), thymosin, oral transfer factor, Bacillus Calmette‐Guerin (BCG) vaccine injection and two kinds of Chinese medicinal herbs (Huangqi granules and TIAOJINING) may help prevent infections in nephrotic children. These studies were methodologically poor. Currently there is no strong evidence for recommending any interventions for preventing infections in nephrotic syndrome. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Chronic obstructive pulmonary disease (COPD): Medication for COPD

Medication is an integral part of the daily treatment of chronic obstructive pulmonary disease (COPD). Although it may not be able to cure the condition, it can help relieve the symptoms and prevent acute breathing problems.The possible treatment options mainly depend on the severity of the disease. In early stages of COPD, people usually only need to take medication when they have acute breathing problems. As the symptoms become more frequent and more severe, certain drugs need to be taken regularly. People who have advanced COPD often take several medications at the same time.These are the most commonly used medications:Drugs that open up the airways (bronchodilators): beta2-agonists, anticholinergics, and methylxanthines if neededAnti-inflammatory drugs: Drugs containing steroids (corticosteroids) and PDE 4 inhibitorsOther drugs called mucolytics are used to dissolve mucus in the bronchi and make it easier to cough it up as phlegm. Antibiotics may also help relieve acute breathing problems. Flu vaccines can prevent additional infections that can make the breathing problems worse.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: August 12, 2015

Late Effects of Treatment for Childhood Cancer (PDQ®): Patient Version

Expert-reviewed information summary about the health problems that continue or appear after cancer treatment has ended.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: December 16, 2015

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