Pneumokokken-Schutzimpfung bei obstruktiven Lungenerkrankungen - Was können wir erwarten?

Zusammenfassung

Die Leitlinien vieler Länder empfehlen Pneumokokken-Schutzimpfungen für Patienten mit obstruktiven Lungenkrankheiten. Diese Arbeit gibt eine Übersicht zur Immunogenität und Sicherheit dieser Maßnahme. Es gibt keine Evidenz für eine nennenswerte Beeinträchtigung oder Gefährdung dieser Patienten durch eine Pneumokokken-Schutzimpfung. Wenige Arbeiten haben sich mit der Bedeutung der Pneumokokken-Schutzimpfung für die Vermeidung von Exazerbationen obstruktiver Lungenkrankheiten befasst. Vorhandene Studien haben diese Fragestellung meist nur als Nebenaspekt untersucht. Die Ergebnisse sind im Kindes- wie Erwachsenenalter imkohärent. Da jedoch die Konjugatvakzine Kinder unter 5 Jahren zusätzlich effektiv vor lebensbedrohlichen invasiven Infektionen schützt, und bei gesunden Erwachsenen bakteriämischen Pneumonien durch die Polysaccharidvakzine vorgebeugt wird, erscheint der Einsatz bei chronisch lungenkranken Patienten gerechtfertigt.

Summary

Many countries’ guidelines recommend pneumococcal vaccination for patients suffering from obstructive airway disease. This paper reviews the literature as to immunogenicity and safety of this immunization. There is no evidence for a negative effect of pneumococcal vaccination on these patients. Only a few data exist on the preventive impact of pneumococcal vaccination as to exacerbations of obstructive airway diseases. Existing studies mostly took up this question as a side aspect. The effect in children and adults appears limited. On the other hand, the pneumococcal conjugate vaccine prevents life-threatening invasive infections in children younger than 5 years, and pneumococcal polysaccharide vaccine protects healthy adults against bacteriaemic pneumonia. Thus, pneumococcal vaccination of patients suffering from obstructive airway disease is recommendable.

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