Pneumonia prevention
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
There are several ways to prevent infectious pneumonia. Appropriately treating underlying illnesses (such as AIDS) can decrease a person's risk of pneumonia. Smoking cessation is important not only because it helps to limit lung damage, but also because cigarette smoke interferes with many of the body's natural defenses against pneumonia.
Research shows that there are several ways to prevent pneumonia in newborn infants. Testing pregnant women for Group B Streptococcus andChlamydia trachomatis, and then giving antibiotic treatment if needed, reduces pneumonia in infants. Suctioning the mouth and throat of infants with meconium-stained amniotic fluid decreases the rate of aspiration pneumonia.
Vaccination is important for preventing pneumonia in both children and adults. Vaccinations against Haemophilus influenzae and Streptococcus pneumoniae in the first year of life have greatly reduced their role in pneumonia in children. Vaccinating children against Streptococcus pneumoniaehas also led to a decreased incidence of these infections in adults because many adults acquire infections from children. A vaccine against Streptococcus pneumoniae is also available for adults. In the U.S., it is currently recommended for all healthy individuals older than 65 and any adults with emphysema, congestive heart failure, diabetes mellitus, cirrhosis of the liver, alcoholism,cerebrospinal fluid leaks, or those who do not have a spleen. A repeat vaccination may also be required after five or ten years.[1]
Influenza vaccines should be given yearly to the same individuals who receive vaccination against Streptococcus pneumoniae. In addition, health care workers, nursing home residents, and pregnant women should receive the vaccine.[2] When an influenza outbreak is occurring, medications such as amantadine, rimantadine, zanamivir, and oseltamivir can help prevent influenza.[3],[4]
- Smoking cessation is important not only for treatment of any underlying lung disease, but also because cigarette smoke interferes with many of the body's natural defenses against CAP.
- Vaccinations against Haemophilus influenzae and Streptococcus pneumoniae in the first year of life have greatly reduced their role in CAP in children.
- A vaccine against Streptococcus pneumoniae and influenza are also available for adults and is currently recommended for all healthy individuals older than 65 and any adults with emphysema, congestive heart failure, diabetes mellitus, cirrhosis, alcoholism, cerebrospinal fluid leaks, or who do not have a spleen.
- A repeat vaccination may also be required after five or ten years.[2]
- In addition, health care workers, nursing home residents, and pregnant women should receive the vaccine.[3]
- When an influenza outbreak is occurring, medications such as amantadine, rimantadine, zanamivir, and oseltamivir have been shown to prevent cases of influenza.[4]
IDSA/ATS guidelines: Recommended vaccine prevention for community-acquired pneumonia in adults [5] (DONOT EDIT)
| Factor | Route of administration | Type of vaccine | Recommended groups | Specific high-risk indications for
vaccination |
Revaccination schedule |
|---|---|---|---|---|---|
| Pneumococcal
polysaccharide vaccine |
Intramuscular injection | Bacterial component (polysaccharide
capsule |
All persons > 65 years of age
High-risk persons 2–64 years of age, Current smokers |
Chronic cardiovascular, pulmonary,
renal, or liver disease, Diabetes mellitus Cerebrospinal fluid leaks Alcoholism Asplenia Immunocompromising conditions/ medications Native Americans and Alaska natives, Long-term care facility residents Residence |
One-time revaccination after 5
years for (1) adults �65 years of age, if the first dose is received before age 65 years; (2) persons with asplenia; and (3) immunocompromised persons |
References
- ↑ Butler JC, Breiman RF, Campbell JF, Lipman HB, Broome CV, Facklam RR. Pneumococcal polysaccharide vaccine efficacy: an evaluation of current recommendations. JAMA 1993;270:1826–1831. PMID 8411526
- ↑ Centers for Disease Control and Prevention. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1999;48(RR-4):1–28. PMID 10366138.
- ↑ Jefferson T, Deeks JJ, Demicheli V, Rivetti D, Rudin M. Amantadine and rimantadine for preventing and treating influenza A in adults.Cochrane Database Syst Rev. 2004;(3):CD001169. PMID 15266442
- ↑ Hayden FG, Atmar RL, Schilling M, Johnson C, Poretz D, Paar D, Huson L, Ward P, Mills RG. Use of the selective oral neuraminidase inhibitor oseltamivir to prevent influenza. N Engl J Med 1999;341:1336–1343PMID 10536125
- ↑ Mandell LA, Wunderink RG, Anzueto A, Bartlett JG, Campbell GD, Dean NC, Dowell SF, File TM, Musher DM, Niederman MS, Torres A, Whitney CG (2007). "Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults". Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 44 Suppl 2: S27–72. doi:10.1086/511159. PMID 17278083. Retrieved 2012-09-06. Unknown parameter
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