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Review
. 2024 Aug 25;16(8):e67771.
doi: 10.7759/cureus.67771. eCollection 2024 Aug.

Effectiveness of Pneumococcal Conjugate Vaccines Over Antibiotic-Resistant Acute Otitis Media in Children: A Systematic Review

Gayanthi Dissanayake  1 , Meaza Zergaw  2 , Mohamed Elgendy  3 , Alvin Billey  4 , Asra Saleem  5 , Bushra Zeeshan  6   7 , Sondos T Nassar  8
Affiliations
Review

Effectiveness of Pneumococcal Conjugate Vaccines Over Antibiotic-Resistant Acute Otitis Media in Children: A Systematic Review

Gayanthi Dissanayake et al. Cureus. .

Abstract

One of the most prevalent childhood illnesses in the world, acute otitis media (AOM), is mainly brought on by Streptococcus pneumoniae, which has resulted in a significant increase in the use of antibiotics and the emergence of antibiotic-resistant (ABR) strains. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 criteria served as the foundation for this systematic review. We conduct a comprehensive literature search across five primary databases, including PubMed, PubMed Central, Cochrane, Science Direct, and Google Scholar, to identify eligible studies assessing the impact of pneumococcal conjugate vaccines (PCVs) on AOM incidence and ABR. Data on AOM rates, shifts in serotype distribution, and the prevalence of ABR pneumococcal strains in children under the age of 18 after PCV implementation are taken from all kinds of studies that assessed any pneumococcal conjugate vaccines (PCV 7, 10, and 13) as interventions. Eighteen records are identified as eligible for the final review. Other articles are excluded by assessing the title and abstract relevancy, applying inclusion criteria, and using critical appraisal tools. Implementing PCVs among children in the national immunization programs in most countries, particularly PCV13 has led to substantial decreases in ABR S. pneumoniae strains. However, serotype replacement has emerged as a challenge, with non-vaccine serotypes becoming more prevalent. Despite this, the overall burden of antibiotic resistance and AOM has decreased, underscoring the positive impact of PCVs on public health. PCVs effectively reduce the incidence of AOM and the prevalence of ABR S. pneumoniae in children. The vaccines play a crucial role in antibiotic stewardship by decreasing the need for broad-spectrum antibiotics. Continued surveillance and development of next-generation vaccines are essential to address serotype replacement and sustain the benefits of PCVs in combating antibiotic-resistant AOM.

Keywords: acute otitis media; antibiotic resistance (abr); pneumococcal conjugate vaccine; serotype; streptococcus pneumoniea.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA flow diagram of the study search selection.
PRISMA; Preferred Reporting Items for Systematic Reviews and Meta-Analyses [13]. PMC; PubMed Central AMSTAR; A critical appraisal tool for systematic reviews that include randomized or non-randomized studies of healthcare interventions, or both NOS; The Newcastle-Ottawa Scale
Figure 2
Figure 2. Incidence of acute otitis media (AOM) cases over 15 years after the introduction of PCV7 and PCV13
PCV; Pneumococcal Conjugate Vaccine Data compiled from study [8].
Figure 3
Figure 3. Serotype coverage by different Pneumococcal Conjugate Vaccines (PCVs)
Data compiled from studies [3] and [21].
See this image and copyright information in PMC

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