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Randomized Controlled Trial
. 2005 Feb;2(2):e38.
doi: 10.1371/journal.pmed.0020038. Epub 2005 Feb 22.

Use of procalcitonin and C-reactive protein to evaluate vaccine efficacy against pneumonia

Shabir A Madhi  1 , Jayvant R Heera, Locadiah Kuwanda, Keith P Klugman
Affiliations
Randomized Controlled Trial

Use of procalcitonin and C-reactive protein to evaluate vaccine efficacy against pneumonia

Shabir A Madhi et al. PLoS Med. 2005 Feb.

Abstract

Background: Pneumonia remains the leading cause of death in young children. The poor specificity of chest radiographs (CXRs) to diagnose pneumococcal pneumonia may underestimate the efficacy of pneumococcal conjugate vaccine in preventing pneumococcal pneumonia.

Methods and findings: The efficacy of nine-valent pneumococcal conjugate vaccine among children not infected with HIV (21%; 95% confidence interval, 1%-37%) increased when CXR-confirmed pneumonia was associated with serum C-reactive protein of 120 mg/l (12 mg/dl) or more and procalcitonin of 5.0 ng/ml or more (64%; 95% confidence interval, 23%-83%). Similar results were observed in children infected with HIV.

Conclusion: C-reactive protein and procalcitonin improve the specificity of CXR to diagnose pneumococcal pneumonia and may be useful for the future evaluation of the effectiveness of pneumococcal conjugate vaccine in preventing pneumococcal pneumonia.

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Conflict of interest statement

Competing Interests: The phase 3 study was supported by a grant from Wyeth-Lederle Vaccines and Pediatrics. SAM has received previous research support and consultancy fees from Wyeth Vaccines and Pediatrics. KPK has received previous research support and consultancy fees from Aventis, Bayer, GlaxoSmithKline, ID Biomedical, Oscient, Roche, and Wyeth-Ayerst.

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