Elsevier

Respiratory Medicine

Volume 100, Issue 10, October 2006, Pages 1671-1681
Respiratory Medicine

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

https://doi.org/10.1016/j.rmed.2006.06.029Get rights and content
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Summary

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.

Keywords

COPD
Chronic bronchitis
Exacerbations
Bacterial
Oral vaccine
Haemophilus influenzae

Cited by (0)

The following Cochrane review has been cited in this Evidence-Based Review: Foxwell AR et al. Haemophilus influenzae oral whole cell vaccination for preventing acute exacerbations of chronic bronchitis. Issue 2, 2003.