An 84 percent decrease in the incidence of pneumococcal infection was seen in the children receiving antibiotic prophylaxis. It is not known if prophylactic doses of penicillin reduce nasopharyngeal carriage of pneumococci. Problems with the use of orally administered prophylactic penicillin in children with sickle cell disease have included reports of breakthrough invasive infections and compliance rates of only 66 percent. The AAP reports that several investigators have also found an increased number of children with sickle cell disease who have nasopharyngeal colonization with penicillin-nonsusceptible strains of pneumococci. Conclusions The AAP concludes that pneumococcal conjugate vaccines are a significant new contribution to the potential control of pneumococcal disease in young children.
Antibiotic prophylaxis helps to protect children with sickle cell disease or splenectomy.
While the use of pneumococcal conjugate vaccines may decrease the need for antibiotic prophylaxis in the future, the emergence of antibiotic-resistant strains of pneumococci threatens to jeopardize the efficacy of current antibiotic prophylactic regimens. The AAP believes that further studies of pneumococcal conjugate vaccines are needed, including studies of the optimal dosage schedules for safety and efficacy for the administration of PCV7 and 23PS vaccine for healthy and high-risk children older than 24 months. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference.