ירחון החברה הישראלית לפדיאטריה אמבולטורית (חיפ"א) גיליון 2018-1

4 סקירות Infectious Disease: Vaccines and Antibiotic Use Rapid Reduction in Disease Burden Following the Introduction of Rotavirus and Pneumococcal Vaccines. In the March 2017 issue of The Journal of Pediatrics 1 , Ben-Shimol and his colleagues from Ben-Gurion University and Soroka University Medical Center, quantified reduced rates of Rota-virus gastroenteritis and Pneumococcal pneumonia hospitalization after the introduction Rotavirus, PC7 and PC13 vaccines. The Rotavirus vaccine was introduced in Israel in 2009; followed by PCV7 in 2010 and PCV13 in 2011. This study compares rates of hospitalization in their facility for children under 2 years of age from 2006 until 2014, for each of Rotavirus gastroenteritis (RVGE), non-RVGE, community acquired alveolar pneumonia (CAAP) and non-alveolar lower respiratory tract infections. Reduced hospitalization rates were achieved for all parameters, 78%, 21%, 46% and 7%, respectively. Outpatient ED rates reduced by 81.7%, 73.5%, 19.9% and 12.3%, respectively. Commentary: The introduction of the RV vaccine has lead to a considerable reduction in disease burden, with a spillover effects to older individuals 2 . New efforts are being made for a newer RV vaccine that is more portable and easier to administer, critical for disease reduction in hard to reach third-world countries 3 . The PCV vaccine has dramatically reduced Pneumococcal disease in the first 2 years of life, contributing to reduced rates of SBI and modifying the protocols for sepsis evaluation 4 . Despite that other strains have come to fill the vacuum left by those vaccinated against, the benefits are quite apparent. Bottom Line: This study is one of several that demonstrate the rapid and considerable reduction in disease burden with the use of RV and PCV vaccines. 1. Shalom Ben-Shimol, MD, Noga Givon-Lavi, PhD, David Greenberg, MD, and Ron Dagan, MD, Co-contribution of Rotavirus and Pneumococcal Conjugate Vaccines to the Reduction of Pediatric Hospital Visits in Young Children. J Pediatr 2017;182:253-9 http://dx.doi.org10.1016/j. jpeds.2016.11.041 2. Wilson SE, et al. Population-Level Impact of Ontario’s Infant Rotavirus Immunization Program: Evidence of Direct and Indirect Effects. Olson DR, ed. PLoS ONE. 2016;11(5):e0154340. doi:10.1371/journal.pone.0154340.