Efficacy of PPV23 in Preventing Pneumococcal Pneumonia in Adults at Increased Risk - A Systematic Review and Meta-Analysis: e0146338

Background Pneumococcal community-acquired pneumonia (pCAP) is the most frequent form of pneumonia. The elderly and adults with underlying diseases are at an increased risk of developing pCAP. The 23-valent pneumococcal polysaccharide vaccine (PPV23) was licensed over 30 years ago and is recommended...

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Bibliographic Details
Published in:PloS one 2016-01, Vol.11 (1)
Main Authors: Schiffner-Rohe, Julia, Witt, Annika, Hemmerling, Jana, Eiff, Christof von, Leverkus, Friedrich-Wilhelm
Format: Article
Language:English
Subjects:
Streptococcus pneumoniae
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Summary:Background Pneumococcal community-acquired pneumonia (pCAP) is the most frequent form of pneumonia. The elderly and adults with underlying diseases are at an increased risk of developing pCAP. The 23-valent pneumococcal polysaccharide vaccine (PPV23) was licensed over 30 years ago and is recommended as the standard intervention in many countries across the globe, although its efficacy continues to be debated. We performed a meta-analysis of randomized controlled trials (RCTs) to investigate the effect of PPV23 for preventing pCAP in adults greater than or equal to 60 years of age. Methods An existing Cochrane Review was updated to Oct 2014 using a systematic literature search to select appropriate RCTs. DerSimonian and Laird random-effects meta-analyses were performed and odd ratios (OR) with 95%-confidence intervals (CI) and p-values were calculated for the descriptive analyses. Reasons for heterogeneity were explored by subgroup analyses. Results Meta-analysis of PPV23 efficacy included four studies. Three of them did not demonstrate efficacy for PPV23. The body of evidence indicated statistically significant heterogeneity (I2 = 78%, p = 0.004) that could be explained by subgroup analysis by "study setting". Further effect modifiers for pCAP were "continent of trial" (p
ISSN:1932-6203
DOI:10.1371/journal.pone.0146338