Pneumococcal vaccine for XXXX .

@entity1 @entity748 @entity66 @entity55 @entity565 @entity328 @entity2346
BACKGROUND: Infection with @entity328 is an important cause of @entity55 and other serious illnesses, particularly amongst those with certain high-risk medical conditions such as @entity565 . Although pneumococcal vaccine is routinely advocated for @entity1 with @entity565 , there is uncertainty about the evidence base that underpins this recommendation. OBJECTIVES: To determine the efficacy of pneumococcal vaccine in reducing mortality or morbidity from @entity66 in @entity748 . SEARCH STRATEGY: Randomised controlled trials were identified using the Cochrane Airways Group's register derived from MEDLINE, EMBASE, and CINAHL electronic databases and hand searched respiratory journals and meeting abstracts. SELECTION CRITERIA: Randomised controlled trials, with or without blinding, in which pneumococcal vaccine has been compared with placebo or no treatment in @entity1 with clinician diagnosed @entity565 . DATA COLLECTION AND ANALYSIS: Two reviewers independently reviewed all abstracts and full papers of all articles of potential relevance were retrieved. Methodological quality was rated using the Cochrane approach and the Jadad rating scale. Data extraction was performed by one reviewer and checked independently by a second. We planned to perform quantitative analyses of outcomes on an intention-to-treat basis, where possible. MAIN RESULTS: Of the three papers retrieved, only one satisfied the inclusion criteria and the methodological quality of this study was low (unblinded and inadequate allocation concealment). None of the data could be aggregated in a meta-analysis. Comparisons in a sub-set of 30 asthmatic @entity1 prone to recurrent episodes of @entity2346 media, showed that pneumococcal vaccination decreased the incidence of acute @entity565 exacerbations from 10 to 7 (per @entity1 per year). A further search conducted in September 2001 did not yield any further studies. REVIEWER'S CONCLUSIONS: This review found very limited evidence to support the routine use of pneumococcal vaccine in @entity1 with @entity565 . A randomised trial of vaccine efficacy in @entity1 and adults with @entity565 is needed.
