Prophylactic antibiotics for preventing pneumococcal infection in children with sickle cell disease

Rankine-Mullings, Angela; Owusu‐Ofori, Shirley

doi:10.1002/14651858.cd003427.pub5

Cited by 13 publications

(9 citation statements)

References 47 publications

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“…A strength of this study is its focus on an important, historically marginalized, and vulnerable pediatric population. Although penicillin prophylaxis is recommended to reduce clinically significant bacterial infections in children under 5 years of age, 13 , 30 breakthrough infections can occur. Theoretically, continuous antibiotic exposure may contribute to the development of antibiotic-resistant pathogens and negatively affect gut microbiome development.…”

Section: Discussionmentioning

confidence: 99%

Safety and immunogenicity of V114, a 15-valent pneumococcal conjugate vaccine, in children with SCD: a V114-023 (PNEU-SICKLE) study

Quinn

Wiedmann

Jarovsky³

et al. 2023

Blood Advances

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Sickle cell disease (SCD) is an inherited red blood cell disease that results in a multitude of medical complications, including increased risk of invasive disease caused by encapsulated bacteria such as Streptococcus pneumoniae. Pneumococcal vaccines have contributed to significant reduction in pneumococcal disease (PD) in children and adults, including those with SCD. This phase 3 study evaluated the safety and immunogenicity of V114, a 15-valent pneumococcal conjugate vaccine (PCV), in children with SCD. A total of 103 children 5 to 17 years of age with SCD were randomized and received a single dose of V114 or Prevnar 13™ (PCV13). Safety was evaluated as the proportion of participants with adverse events (AEs). Serotype-specific immunoglobulin G (IgG) and opsonophagocytic activity (OPA) were measured immediately prior to and 30 days after vaccination. Overall, rates of injection-site and systemic AEs reported postvaccination were similar between vaccination groups. Up to 6 months postvaccination, serious AEs were those expected in SCD patients, and none was assessed to be vaccine related. IgG geometric mean concentrations (GMCs) and OPA geometric mean titers (GMTs) for 13 shared serotypes were generally comparable between recipients of V114 and PCV13. Additionally, V114 induced immune responses to serotypes 22F and 33F, not included in PCV13. Safety and tolerability profiles of V114 were consistent to those reported with PCV13. Immune responses following vaccination with V114 were generally comparable to PCV13 for the shared serotypes and higher for unique serotypes 22F and 33F. These results support the use of V114 in children with SCD. Trial Registration: ClinicalTrials.gov: NCT03731182; EudraCT: 2018-001152-35.

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Section: Discussionmentioning

confidence: 99%

Safety and immunogenicity of V114, a 15-valent pneumococcal conjugate vaccine, in children with SCD: a V114-023 (PNEU-SICKLE) study

Quinn

Wiedmann

Jarovsky³

et al. 2023

Blood Advances

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“…The high incidence of infections observed among participants in the current study may be explained by the failure in implementing an effective immunization protocol and the physician's nonadherence to guidelines, regarding antibiotic prophylaxis for children with SCD. Initiation of penicillin prophylaxis up to the age of 5 years, in addition to vaccination, is recommended to reduce the risk of developing serious bacterial infections [ 14 , 15 , 25 ]. Low prescription rates of prophylactic penicillin may be attributed to fear from the emergence of penicillin resistance, noncompliance of physicians to treatment guidelines, and nonadherence to medications in SCD patients [ 15 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Sickle Cell Disease in Sudan: Complications and Management

Talha

Osman

Abdalla

et al. 2022

Anemia

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Background. Sickle cell disease (SCD) is a life-threatening genetic disorder due to the formation of sickle hemoglobin molecule (HbS) that polymerizes in hypoxic conditions leading to SCD-related complications. Different approaches have been used in the management of SCD including symptomatic management, supportive management, and preventive management. Objectives. To assess the management of SCD in pediatric patients in Gaafar Ibnauf Referral Hospital in Khartoum locality, Sudan. Method. A descriptive, retrospective, hospital-based study was conducted in Gaafar Ibnauf Hospital using a data collection sheet. The study included all medical files of pediatric patients with SCD attending the hospital during the period from the first of April 2018 to the first of July 2018. The data were analyzed using descriptive statistics and the chi-square test. P < 0.05 was considered statistically significant. Results. Out of 207 pediatric patients, 53.1% were females (mean age of 7.5 ± 3.1 years), with a 1.1 : 1 female:male ratio and low socioeconomic status. Only 4.3% of participants had health insurance. The Messeryia tribe in western Sudan had the highest prevalence of the disease among the Sudanese tribes (11.1%). Vaso-occlusive crisis (33.3%), infections (13.5%), and neurological complications (10.6%) were the most frequent complications reported during routine visits. After initiation of management, only 3.4% of pediatric patients had hemolytic crises, and 1.4% of the anemic patients had splenomegaly. 100% of patients received folic acid, 73.9% used hydroxyurea, and 69.6% underwent blood transfusion for the management of SCD. Prophylactic penicillin was prescribed for 15% of patients, and 41.1% were immunized with pneumococcal vaccine (PPSV23). Most patients had been scheduled for planned follow-up visits every 3–6 months (93.2%). Hydroxyurea and blood transfusion significantly reduced fever and vaso-occlusive crisis. Conclusion. The SCD treatment protocol in Gaafar Ibnauf Children’s Hospital, involving preventive and symptomatic therapy, is consistent with the internationally implemented protocols for SCD management. However, immunization and prophylactic penicillin approaches are deficient.

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“…La mayoría de los pacientes recibió el tratamiento recomendado, profilaxis antibiótica 21 , transfusiones 22 e hidroxiurea 17 .…”

Section: Discussionunclassified

Enfermedad de células falciformes en una unidad de referencia de hematología pediátrica

Quezada

G.²,

F³

et al. 2022

Andes pediatr

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La enfermedad de células falciformes (ECF) es una hemoglobinopatía de herencia autosómica recesiva. La prevalencia de ECF puede cambiar especialmente por fenómenos migratorios. Objetivo: Describir las características de pacientes con ECF, al diagnóstico, en un hospital de referencia a lo largo de una década. Pacientes y Método: Estudio retrospectivo de las características clínicas y de laboratorio de menores de 15 años con ECF, diagnosticados en el Servicio de Onco-Hematología del Hospital Dr. Roberto del Rio, Santiago de Chile, entre abril 2008 y marzo 2018. Se evaluó sexo, edad, nacionalidad, síntomas, características del hemograma y resultados de electroforesis de hemoglobina. Los datos se analizaron mediante análisis estadístico descriptivo. Resultados: Dieciséis pacientes fueron diagnosticados de ECF, 2 eran portadoras sanas y se excluyeron. De los 14 analizados, 2 se diagnosticaron antes del 2015. Doce eran varones, 9 eran chilenos y 13 tenían progenitores extranjeros. Ocho tenían menos de 2 años y 12 fueron sintomáticos. Los síntomas más frecuentes fueron dolor de extremidades y anemia. La mediana de hemoglobina fue 8,2 g/dL (6,2-12,3). Se observaron drepanocitos en 11 de 14 pacientes, en 4 mediante test de metabisulfito. En 13/14, se realizó electroforesis de hemoglobina: mediana de hemoglobina S 70,2% (28,2-87,1) y de hemoglobina F 18,7% (0-32,3). Un paciente tenía estudio genético. Trece pacientes continuaban en control, 84,6% recibían ácido fólico y amoxicilina, 53,8% requerían transfusiones y 69,2% habían iniciado hidroxiurea. Conclusión: La ECF ha aumentado en Chile; por ende se debe tener un alto grado de sospecha y mejorar localmente su diagnóstico, tratamiento y seguimiento.

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Prophylactic antibiotics for preventing pneumococcal infection in children with sickle cell disease

Cited by 13 publications

References 47 publications

Safety and immunogenicity of V114, a 15-valent pneumococcal conjugate vaccine, in children with SCD: a V114-023 (PNEU-SICKLE) study

Safety and immunogenicity of V114, a 15-valent pneumococcal conjugate vaccine, in children with SCD: a V114-023 (PNEU-SICKLE) study

Pediatric Sickle Cell Disease in Sudan: Complications and Management

Enfermedad de células falciformes en una unidad de referencia de hematología pediátrica

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