Efficacy of 23-valent pneumococcal vaccine in preventing pneumonia and improving survival in nursing home residents: double blind, randomised and placebo controlled trial.
BMJ
; 340: c1004, 2010 Mar 08.
Article
em En
| MEDLINE
| ID: mdl-20211953
ABSTRACT
OBJECTIVE:
To determine the efficacy of a 23-valent pneumococcal polysaccharide vaccine in people at high risk of pneumococcal pneumonia.DESIGN:
Prospective, randomised, placebo controlled double blind study.SETTING:
Nursing homes in Japan.PARTICIPANTS:
1006 nursing home residents.INTERVENTIONS:
Participants were randomly allocated to either 23-valent pneumococcal polysaccharide vaccine (n=502) or placebo (n=504). MAIN OUTCOMEMEASURES:
The primary end points were the incidence of all cause pneumonia and pneumococcal pneumonia. Secondary end points were deaths from pneumococcal pneumonia, all cause pneumonia, and other causes.RESULTS:
Pneumonia occurred in 63 (12.5%) participants in the vaccine group and 104 (20.6%) in the placebo group. Pneumococcal pneumonia was diagnosed in 14 (2.8%) participants in the vaccine group and 37 (7.3%) in the placebo group (P<0.001). All cause pneumonia and pneumococcal pneumonia were significantly more frequent in the placebo group than in the vaccine group incidence per 1000 person years 55 v 91 (P<0.0006) and 12 v 32 (P<0.001), respectively. Death from pneumococcal pneumonia was significantly higher in the placebo group than in the vaccine group (35.1% (13/37) v 0% (0/14), P<0.01). The death rate from all cause pneumonia (vaccine group 20.6% (13/63) v placebo group 25.0% (26/104), P=0.5) and from other causes (vaccine group 17.7% (89/502) v placebo group (80/504) 15.9%, P=0.4) did not differ between the two study groups.CONCLUSION:
The 23-valent pneumococcal polysaccharide vaccine prevented pneumococcal pneumonia and reduced mortality from pneumococcal pneumonia in nursing home residents. Trial registration Japan Medical Association Center for Clinical Trials JMA-IIA00024.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pneumonia Pneumocócica
/
Vacinas Pneumocócicas
/
Casas de Saúde
Tipo de estudo:
Clinical_trials
Limite:
Aged
/
Aged80
/
Humans
/
Middle aged
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2010
Tipo de documento:
Article