Efficacy of Pneumococcal Vaccine on Otitis Media: A Systematic Review and Meta-Analysis.

Abstract

OBJECTIVE:

To assess the effect of the pneumococcal vaccine (PCV) toward the surgical management and complications of otitis media.

DATA SOURCES:

MEDLINE, EMBASE, PubMed, Scopus, and clinicaltrial.gov.

REVIEW METHODS:

A systematic search was performed using a combination of keywords and standardized terms about PCV and surgical management or complications of otitis media. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studies were screened by 3 independent reviewers. Risk of bias assessment, followed by meta-analysis in only randomized-controlled trials was conducted. Vaccine efficacy (VE) and 95% confidence interval (CI) were reported.

RESULTS:

Of the 2649 abstracts reviewed, 27 studies were included in the qualitative analysis and were categorized into 6 outcomes: tympanostomy tube insertion, otitis media with effusion (OME), mastoiditis, spontaneous tympanic membrane (TM) perforation, recurrent acute otitis media (AOM), and severe AOM. Fifteen studies were included in the meta-analysis to evaluate the rate of tympanostomy tube insertion, OME, and recurrent AOM. PCV was significantly more effective in lowering the rate of tympanostomy tube insertion (VE, 22.2%; 95% CI, 14.6-29.8) and recurrent AOM (VE, 10.06%; 95% CI, 7.46-12.65) when compared with the control group, with no significant difference in reducing the incidence of OME. The qualitative analysis revealed that PCV had efficacy in preventing severe AOM and spontaneous TM perforation but the effect on mastoiditis remained unclear.

CONCLUSION:

The PCV was effective in reducing the rate of tympanostomy tube insertion and the incidence of recurrent AOM with a nonsignificant effect in preventing OME in children.

• Authors: Thanakrit Wannarong, Pichamon Ekpatanaparnich, Adhiratha Boonyasiri, Orawan Supapueng, Vannipa Vathanophas, Archwin Tanphaichitr, Kitirat Ungkanont
• Journal: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery (Otolaryngol Head Neck Surg) Vol. 169 Issue 4 Pg. 765-779 (10 2023) ISSN: 1097-6817 [Electronic] England
• PMID: 36924215 (Publication Type: Meta-Analysis, Systematic Review, Journal Article, Review)
• Copyright: © 2023 The Authors. Otolaryngology-Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology-Head and Neck Surgery Foundation.

Chemical References

• Pneumococcal Vaccines

Topics

• Child
• Humans
• Infant
• Pneumococcal Vaccines (therapeutic use)
• Mastoiditis
• Otitis Media (prevention & control, surgery)
• Otitis Media with Effusion (prevention & control, surgery)
• Middle Ear Ventilation