Bacterial pneumonia primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Arooj Naz
Overview
The goal of Primary prevention is to prevent the occurrence of an illness or a disease before it ever occurs. In the case of bacterial pneumonia, primary prevention can be achieved by the administration of vaccination as well as attempting to control underlying comorbidities that may predispose an individual to pneumonia. Pneumococcus Vaccines include the PCV13 (Conjugate vaccine) and the PPSV23 (Polysaccharide vaccine). The PCV13 vaccine is indicated in infants and childhood routine vaccines (children younger than 2 years) as well as all adults aged 65 years or older whereas the PPSV23 vaccine is recommended for all adults over the age of 65 as well as adults aged 19-64 with certain medical conditions including chronic heart, lung, or liver diseases, diabetes, smokers and alcoholics. The killed intramuscular influenza vaccine should be given annually. Strict blood glucose and blood pressure control can help in preventing disease prevalence. When certain conditions are present, such as in children that have asplenia, it may also be helpful to treat with prophylactic antibiotics.[1] Educating the public as well as identifying those most susceptible to infection can help reduce the risk of pneumonia.
Vaccinations
- Routinely administered vaccines include:
- Pneumococcus (Intramuscular Conjugate or polysaccharide vaccine)
- Annual vaccine against H. influenza (Intramuscular killed vaccine)
| Advantages | Disadvanatges | Indications | |
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| PCV13 (Conjugate vaccine) |
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| PPSV23 (Polysaccharide vaccine) |
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| PCV13 + PPSV23 |
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Controlling Underlying Comorbidities and Patient Education
- Comorbidities significantly increase the risk of bacterial pneumonia and should be controlled to aid in prevention. These include:
- Strict blood glucose and blood pressure control
- Seeking treatment for chronic lung conditions such as COPD and Asthma
- Smoking Cessation
- Abstaining from alcohol overuse
- Maintaining good dental hygiene
- The elderly and immunocompromised should consider medical assistance if they develop worrisome symptoms such as a fever accompanied by dyspnea and rigors[4]
Conditions Requiring Prophylaxis
For children that have asplenia (including functional asplenia, as seen in sickle-cell disease), daily antimicrobial prophylaxis with oral penicillin V in addition to immunization is recommended. For patients with a history of splenectomy, antibiotics should be continued for a period of 1 year after the surgery.[1]
References
- ↑ 1.0 1.1 https://www.cdc.gov/pneumococcal/clinicians/prevention.html. Missing or empty
|title=(help) - ↑ Hayward S, Thompson LA, McEachern A (2016). "Is 13-Valent Pneumococcal Conjugate Vaccine (PCV13) Combined With 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV23) Superior to PPSV23 Alone for Reducing Incidence or Severity of Pneumonia in Older Adults? A Clin-IQ". J Patient Cent Res Rev. 3 (2): 111–115. doi:10.17294/2330-0698.1214. PMC 4927079. PMID 27376105.
- ↑ Grief SN, Loza JK (2018). "Guidelines for the Evaluation and Treatment of Pneumonia". Prim Care. 45 (3): 485–503. doi:10.1016/j.pop.2018.04.001. PMC 7112285 Check
|pmc=value (help). PMID 30115336. - ↑ "StatPearls". 2022. PMID 30020693.