PPSV23 Decreased Sinusitis, Antibiotic Use in Pediatric Patients
Researchers explored the association of a pneumococcal polysaccharide vaccine booster and health care utilization in children with sinusitis and low pneumococcal antibody titers.
The pneumococcal polysaccharide vaccine booster (PPSV23) was linked to a decrease in sinusitis events and antibiotic use among pediatric patients, according to data published in the International Journal of Pediatric Otorhinolaryngology.1
“Acute rhinosinusitis is one of the most common pediatric bacterial infections and a significant driver of health care utilization,” wrote authors of the study. “As of 1996, treatment for acute sinusitis in children under 12 resulted in $1.8 billion in health care spending.”
Upper respiratory tract infections (URI), also known as the common cold, are likewise prevalent among pediatric patients. According to Johns Hopkins Medicine, most adolescents experience around 6 to 8 colds annually.2 These URIs among children then turn into acute rhinosinusitis 5%-10% of the time. Patients who develop acute rhinosinusitis typically go on to experience rhinorrhea, nasal obstruction, fever, cough, headache, and facial discomfort, leading to a need for antibiotic prescriptions in 82% of medical visits for rhinosinusitis.1
Among pediatric patients, researchers wanted to explore health care utilization trends before and after the delivery of a PPSV23 dose. | image credit: Pixel-Shot / stock.adobe.com
READ MORE: Cost-Effectiveness of PCV15, 20 Vaccines Expected to Decrease
“The most common organisms implicated in acute bacterial rhinosinusitis are S. pneumoniae, H. influenzae, and M. catarrhalis,” continued the authors. “In the conjugated-pneumococcal vaccine era, S. pneumoniae is implicated in ∼30% of cases of acute bacterial rhinosinusitis. However, both before and after the introduction of conjugated-pneumococcal vaccines, a subset of pediatric patients [has] been shown to generate ineffective long-term pneumococcal immunity as measured by anti-S. pneumoniae antibody titers.”
Among pediatric patients with sinusitis and low pneumococcal titers, researchers wanted to explore health care utilization trends before and after the delivery of a PPSV23 dose. They hypothesized a decrease in both health care encounters and antibiotic prescriptions after immunization, but not for immunocompromised patients.
“It is known that patients with recurrent respiratory infections may have inadequate pneumococcal antibody titers representing poor state of defense against polysaccharide bacteria,” wrote authors of a study published in Allergy & Rhinology.3 “For these patients, polysaccharide pneumococcal vaccine (PPV) is recommended for evaluation and boosting of independent humoral immunity.”
With previous evidence at their disposal, researchers believed they were well-aligned to hypothesize successful vaccination outcomes among a pediatric population with sinusitis and low pneumococcal titers. To understand the association between PPSV23 and health care utilization, researchers explored sinusitis-related health care encounters and antibiotic prescriptions 2 years before and after PPSV23 booster.1
They included a total of 223 pediatric patients (mean age at pre-vaccination titer, 7.99 years; 56.2% boys) aged 2 to 16 years old. When comparing the time before participants received PPSV23 with the post-vaccination period, sinusitis-related encounters decreased on average from 2.7 to 1.23. There was also a reduction in average antibiotic prescriptions, decreasing from 2.58 to 1.18.
“Among patients in this cohort, PPSV23 vaccination was associated with a 51% drop in sinusitis-related health care encounters and antibiotic use,” wrote the authors.1 “Immunocompromised patients had a similar, though reduced, response, with a decrease of 47%-49%.”
Confirming the researchers’ hypothesis, they identified a positive association between the PPSV23 booster and health care utilization. Furthermore, they even discovered the same association among immunocompromised pediatric patients, which was the only part of their hypothesis that was unsuccessful.
While previous studies have explored positive outcomes within cases of PPSV23 boosters, few have explored this association since the acceptance of pneumococcal conjugate vaccines (PCV15 and PCV20), which are now the CDC-recommended vaccine schedules for children, along with PPSV23.4 With multiple options available for children to stay protected against pneumococcal-related diseases and other complications, future research will focus on the PPSV23 booster’s effects.
“Booster vaccination with PPSV23 among pediatric patients with sinusitis may be associated with a decrease in sinusitis-related health care encounters and antibiotic use by up to 51%. Among immunocompromised patients, PPSV23 may also be associated with decreased sinus-related health care encounters and antibiotic use. Future studies should involve a randomized, prospective trial of PPSV23 booster vaccination in this cohort to more precisely assess its effects,” concluded authors of the study.1
READ MORE: Pneumococcal Resource Center
Ready to impress your pharmacy colleagues with the latest drug information, industry trends, and patient care tips? Sign up today for our free Drug Topics newsletter.
