Specific Varicella-Related Complications and Their Decrease in Hospitalized Children after the Introduction of General Varicella Vaccination: Results from a Multicenter Pediatric Hospital Surveillance Study in Bavaria (Germany)

Hagemann, Christine; Krämer, Alexander; Grote, Veit; Liese, Johannes G.; Streng, Andrea

doi:10.1007/s40121-019-00273-6

Cited by 10 publications

(7 citation statements)

References 47 publications

(69 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, varicella can result in severe complications leading to hospitalisation and comorbidities. These can range from dehydration and skin infections to pneumonia and encephalitis [ 11 ]. It is reported that 2–6% of patients with varicella infection attending general practice develop complications [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Assessing the use of antibiotics and the burden of varicella in Belgium using a retrospective GP database analysis

Vandenhaute

Tsakeu²,

Chevalier³

et al. 2021

BMC Infect Dis

View full text Add to dashboard Cite

Background Varicella is a highly contagious infection that typically occurs in childhood. While most cases have a generally benign outcome, infection results in a considerable healthcare burden and serious complications may occur. Objectives The objective of this study was to characterize the burden of varicella in a real-world primary care setting in Belgium, including the rate of varicella-related complications, medication management and general practitioner (GP) visits. Methods The study was a retrospective observational study using data from a longitudinal patient database in a primary care setting in Belgium. Patients with a GP visit and a varicella diagnosis between January 2016 and June 2019 were eligible and data one month prior and three months after the diagnosis were included. Outcomes included varicella-related complications, antibiotic use, antiviral use, and GP follow-up visits. Antibiotic use could be specified by class of antibiotic and linked to a diagnosis. Complications were identified based on concomitant diagnosis with varicella during the study period. Results 3,847 patients with diagnosis of varicella were included, with a mean age of 8.4 years and a comparable distribution of gender. 12.6% of patients with varicella had a concomitant diagnosis of a varicella-related complication. During the follow-up period, 27.3% of patients with varicella were prescribed antibiotics, either systemic (19.8%) and/or topical (10.3%). The highest rate of antibiotic prescriptions was observed in patients with complications (63.5%) and in patients younger than 1 year (41.8%). Nevertheless, 5.3% of the patients were prescribed antibiotics without a concomitant diagnosis of another infection. The most commonly prescribed systemic antibiotics were amoxicillin alone or combined with beta-lactamase inhibitor, and thiamphenicol. Fusidic acid and tobramycin were the most prescribed topical antibiotics. Antivirals were prescribed for 2.7% of the study population. 4.7% of the patients needed a follow-up visit with their GP. Conclusions This study reports a substantial burden of varicella in a primary care setting in Belgium, with high rates of complications and antibiotic use.

show abstract

Section: Introductionmentioning

confidence: 99%

Assessing the use of antibiotics and the burden of varicella in Belgium using a retrospective GP database analysis

Vandenhaute

Tsakeu²,

Chevalier³

et al. 2021

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…From 1999 to 2007, deaths occurred in a greater number of involved immunocompromised patients (29%) than deaths reported for immunocompetent individuals (11–18%) [ 22 ]. Although vaccination has been shown to reduce the incidence of complications and varicella-related hospitalizations overall, a German varicella surveillance project noted significantly more varicella-related complications in immunocompromised patients, including hematologic complications and systemic bacterial infections [ 23 ]. Even with vaccination becoming common practice in many countries, a systematic review of breakthrough varicella noted severe breakthrough disease in healthy and immunocompromised children [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Varicella zoster immune globulin (human) (VARIZIG) in immunocompromised patients: a subgroup analysis for safety and outcomes from a large, expanded-access program

Gans

Chemaly

2021

BMC Infect Dis

View full text Add to dashboard Cite

Background Immunocompromised children and adults are at increased risk for severe disease and death following varicella zoster virus infection. Varicella zoster immune globulin (human) (VARIZIG) is recommended for post-exposure prophylaxis to prevent or attenuate varicella infection in high-risk individuals. Methods An open-label, expanded-access program provided VARIZIG to high-risk individuals exposed to varicella or herpes zoster. Immunocompromised participants were stratified by type of immunocompromising condition (“oncologic immunodeficiency”, “primary immunodeficiency”, “solid organ transplant” [SOT], “hematopoietic cell transplant” [HCT], and “other”). Patient characteristics, type of exposure and varicella outcome, and safety data were assessed. Results This analysis included 40 adults (primary [n = 6] or oncologic [n = 10] immunodeficiencies, history of SOT [n = 5] or HCT [n = 6], and other [n = 13]), and 263 children (primary [n = 13] or oncologic [n = 152] immunodeficiencies, history of SOT [n = 36] or HCT [n = 17], and other [n = 45]). Among adults and children, 48% vs 72% were exposed to varicella, 38% vs 16% were exposed to herpes zoster, and 15% vs 12% had an unspecified exposure. Overall incidence of varicella infection in adults after VARIZIG use was 6%; incidence of varicella infection in children after VARIZIG use was 7%. Similar rates were noted in each subgroup. Most cases of varicella were mild, with two children developing > 100 lesions and no cases of varicella-related pneumonia or encephalitis. Varicella-related hospitalizations occurred primarily in children with oncologic immunodeficiencies. One serious adverse event (serum sickness) was considered related to VARIZIG and occurred in a child with oncologic immunodeficiency. There were no varicella- or VARIZIG-related deaths. Conclusions These data indicate that VARIZIG may reduce severity of varicella in immunocompromised children and adults. Trial registration This study was retrospectively registered with the public clinical trial identification NCT00338442 at https://www.clinicaltrials.gov on 20 June 2006.

show abstract

Section: Methodsmentioning

confidence: 99%

“…Varicella infection and complications were identified using ICD-10 codes and sorted into categories that included skin disorders, systemic bacterial infections, neurological conditions, upper and lower respiratory tract infections, ear, nose and throat conditions, musculoskeletal disorders, ophthalmic conditions and gastrointestinal disorders. Within each category, common complications associated with varicella were selected based on literature review 1,12,[19][20][21][22][23][24][25][26][27][28][29][30][31] Prescribed medications were classified as antivirals, antibiotics (systemic antibiotics and nonsystemic/topical antibiotics), emollients, analgesics or antihistamines, with further subgroup analysis performed for specific systemic antibiotics. Specific systemic antibiotics were selected from a list defined by the Haute Autorité de Santé of common antibiotics used for the treatment of pediatric patients with the complications included in our analysis.…”

Section: Study Measuresmentioning

confidence: 99%

Clinical and Economic Burden of Antibiotic Use Among Pediatric Patients With Varicella Infection in the Outpatient Setting: A Retrospective Cohort Analysis of Real-world Data in France

Kujawski,

Casey,

Haas

et al. 2024

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

Background: Varicella infects 90% of children before age 9. Though varicella is self-limiting, its complications may require antibiotics, though how antibiotics are utilized for varicella in France is not well known. This study assessed antibiotic use and costs associated with varicella and its complications in pediatric patients managed in the outpatient setting in France. Methods: A retrospective cohort study using the Cegedim Strategic Data-Longitudinal Patient Database, an electronic medical record database from general practitioners and office-based specialists in France, was conducted. Children <18 years old diagnosed with varicella between January 2014 and December 2018 with 3-month follow-up available were included. We used descriptive analysis to assess varicella-related complications, medication use, healthcare resource utilization and costs. Results: Overall, 48,027 patients were diagnosed with varicella; 15.3% (n = 7369) had ≥1 varicella-related complication. Antibiotics were prescribed in up to 25.1% (n = 12,045/48,027) of cases with greater use in patients with complications (68.1%, n = 5018/7369) compared with those without (17.3%, n = 7027/40,658). Mean medication and outpatient varicella-related costs were €32.82 per patient with medications costing a mean of €5.84 per patient; antibiotics contributed ~23% to total costs annually. Conclusion: This study showed high antibiotic use for the management of varicella and its complications. A universal varicella vaccination program could be considered to alleviate complications and associated costs in France.

show abstract

Specific Varicella-Related Complications and Their Decrease in Hospitalized Children after the Introduction of General Varicella Vaccination: Results from a Multicenter Pediatric Hospital Surveillance Study in Bavaria (Germany)

Cited by 10 publications

References 47 publications

Assessing the use of antibiotics and the burden of varicella in Belgium using a retrospective GP database analysis

Assessing the use of antibiotics and the burden of varicella in Belgium using a retrospective GP database analysis

Varicella zoster immune globulin (human) (VARIZIG) in immunocompromised patients: a subgroup analysis for safety and outcomes from a large, expanded-access program

Clinical and Economic Burden of Antibiotic Use Among Pediatric Patients With Varicella Infection in the Outpatient Setting: A Retrospective Cohort Analysis of Real-world Data in France

Contact Info

Product

Resources

About