Centre for International Child Health, University of Melbourne, Royal
Children's Hospital, Parkville, Victoria, Australia.
Otitis media (OM) is one of the commonest infections in childhood and a
frequent reason for prescribing antibacterials in infancy. However, the
increase in prevalence of antibacterial-resistant respiratory bacterial
pathogens has not been matched by the development of new antibacterial agents.
Bacterial vaccine strategies aim to prevent OM directly and to reduce
nasopharyngeal carriage of pneumococci, thereby reducing the likelihood of
developing acute OM. Complete protection against OM would require an approach
targeting both bacterial and viral agents. Immunisation with a pneumococcal
conjugate vaccine provides protection against acute OM caused by pneumococcal
serotypes included in the vaccine, reduces serotype-specific pneumococcal
carriage, and reduces carriage of penicillin-resistant pneumococci.
However, an increase in non-vaccine
serotype OM has been observed in vaccinated children, which may limit the
overall effectiveness of this vaccine. New vaccines targeting non-typable
Haemophilus influenzae and Mycoplasma catarrhalis are in the early stages of
development. Efficacy studies with influenza vaccine have shown the most
promising results to date in terms of overall reduction in OM episodes. A more
substantial reduction in the burden of OM in childhood would require a
combination of vaccines that are effective against the bacterial and viral
pathogens involved and that can be administered early in infancy.
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MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.