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Oral bacterial vaccines for the prevention of acute exacerbations in chronic obstructive pulmonary disease and chronic bronchitis

journal contribution
posted on 2023-05-16, 18:24 authored by Arandjus, C, Black, PN, Poole, PJ, Wood-Baker, R, Steurer-Stey, C
Oral vaccines using killed bacterial extracts have been used to prevent acute exacerbations of chronic obstructive pulmonary disease (COPD); however, they are not recommended by current clinical guidelines. Two systematic reviews have been published on the efficacy of oral vaccines. The first, on the effects of an oral whole-cell nontypeable Haemophilus influenzae vaccine (NTHi) found a significant decrease in the incidence of acute episodes of chronic bronchitis (Poisson rate ratio 0.666; 95% confidence interval (CI) 0.500, 0.887; P=0.005), and a 58% reduction in the prescription of antibiotics 3 months after vaccination. The second review evaluated studies that used multicomponent vaccines. It found that the duration of exacerbations was significantly shorter in the treatment group (weighted mean difference -2.7 days, 95% CI -3.5 to -1.8). These reviews suggest that oral vaccines reduce the number, severity, duration, or both, of acute exacerbations. However, many of the primary trials on which they are based are small and methodologically flawed. Further trials are needed before the use of oral vaccines could be considered as part of the routine clinical management of patients with COPD or chronic bronchitis. © 2006 Elsevier Ltd. All rights reserved.

History

Publication title

Respiratory Medicine

Volume

100

Issue

10

Pagination

1671-1681

ISSN

0954-6111

Department/School

Tasmanian School of Medicine

Publisher

W B SAUNDERS CO LTD

Place of publication

England

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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    University Of Tasmania

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