Dosing schedule of pneumococcal vaccine linked with increased risk of getting multiresistant strain

 2010 study posted for filing

Contact: Elisabeth A. M. Sanders, M.D., Ph.D. l.sanders@umcutrecht.nl JAMA and Archives Journals

This release is also available in Chinese on EurekAlert! Chinese.

Infants who received heptavalent pneumococcal conjugate vaccination (PCV-7) at 2, 4, and 11 months were more likely than unvaccinated controls to have nasopharyngeal (in the nasal passages and upper part of the throat behind the nose) acquisition of pneumococcal serotype 19A, a leading cause of respiratory pneumococcal disease, according to a study in the September 8 issue of JAMA.

“A rapid increase in the presence of pneumococcal serotype 19A strains that are often multiresistant to antibiotics has been observed over the last decade. In the United States, serotype 19A is now the leading causative pneumococcal serotype of invasive and respiratory pneumococcal disease and the most frequently observed serotype in nasopharyngeal carriage. In the United States and other countries, the increase in serotype 19A disease was associated in time with the widespread implementation of PCV-7 in routine infant immunization programs,” according to background information in the article. “Because spontaneous fluctuations in time and antibiotic selective pressure may have induced this serotype 19A increase, controlled studies are needed to assess the role of PCV-7.”

Elske J. M. van Gils, M.D., of University Medical Center Utrecht, the Netherlands, and colleagues examined the association between PCV-7 vaccination and nasopharyngeal acquisition of serotype 19A pneumococci in 1,003 healthy newborns, with follow-up to the age of 24 months in the Netherlands, which has low antibiotic resistance rates. The study was conducted before widespread PCV-7 implementation in infants, between July 2005 and February 2008. Nasopharyngeal swabs were obtained at the age of 6 weeks and at 6, 12, 18, and 24 months. Infants were randomly assigned to receive 2 doses of PCV-7 at 2 and 4 months; 2 + 1 doses of PCV-7 at 2, 4, and 11 months; or no dosage (unvaccinated control group).

Nine hundred forty-eight children completed the study. Fifty-four nasopharyngeal serotype 19A carriage isolates from 318 in the 2-dose group, 66 isolates from 327 in the 2 + 1-dose group, and 33 isolates from 303 in the unvaccinated group were collected from 6 weeks through 24 months. “At 24 months and after having completed the vaccine series, the cumulative proportion of participants with acquisition of a new serotype 19A clone in the 2 +1-dose group was 16.2 percent (53 of 327) vs. 9.2 percent (28 of 303) in the unvaccinated control group. The cumulative proportion in the 2-dose group was also higher than in the unvaccinated group but did not reach statistical significance (13.2 percent; 42 of 318 children),” the authors write.

The proportion of children with new 19A acquisition who had used antibiotics in the last 6 months (18.7 percent) did not differ among groups.

“In addition to the contributing role of antibiotic selective pressure as previously described by others, we now have demonstrated, to our knowledge for the first time, the facilitating role of PCV-7 in nasopharyngeal acquisition of serotype 19A. In view of the proven disease potential of serotype 19A for otitis media and invasive pneumococcal disease and the observed association with antibiotic resistance, vaccines of broader coverage including protection against serotype 19A may further aid to pneumococcal disease prevention. However, we need to be aware that other serotypes with similar characteristics and disease potential may be the next in line to proliferate and therefore pneumococcal surveillance remains important after introduction of expanded pneumococcal conjugate vaccines,” the researchers conclude.

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(JAMA. 2010;304[10]:1099-1106. Available pre-embargo to the media at www.jamamedia.org)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Licorice extract provides new treatment option for canker sores

Re-post for filing 2008

Contact: Stefanie Schroeder
media@agd.org
312-440-4346
Academy of General Dentistry

CHICAGO (May 22, 2008) – What common oral condition appears as shallow ulcers of different sizes, affects one in five Americans, can be caused by food allergies and hormonal changes, and also can cause severe mouth pain? Commonly referred to as “canker sores,” recurrent aphthous ulcers (RAU) now can be treated by an extract in licorice root herbal extract, according to a study published in the March/April 2008 issue of General Dentistry, the Academy of General Dentistry’s (AGD) clinical, peer-reviewed journal.

The authors examined the effects of an over-the-counter medicated adhesive patch (with extract from the licorice root) for treatment of RAU versus no treatment. After seven days of treatment, ulcer size in the group who received the adhesive patch with licorice extract was significantly lower, while ulcer size in the no-treatment group had increased 13 percent.

Licorice root extract was used as a prescribed treatment for gastric ulcers until the 1970s, according to the study. In its original form, licorice root extract has a very strong taste. However, when combined with a self-adhering, time-release, dissolving oral patch, the taste is mild and pleasant.

Among the causes of canker sores, a genetic predisposition might be the biggest cause, says Michael Martin, DMD, PhD, lead author of the study. “When both parents have a history of canker sores, the likelihood of their children developing them can be as high as 90 percent,” he says.

The most serious side effect of canker sores is sharp pain in the mouth, which can interfere with an individual’s quality of life and affect their eating, drinking or speech. Dr. Martin revealed that “in addition to speeding healing of the canker sores, the adhesive patch helped to reduce pain after just three days of treatment.”

Those who experience canker sores on a regular basis can visit their dentist for treatment techniques. “Dentists can give patients the proper medication and treatment options to seal the lesions, which will prevent further infection,” says Eric Shapira, DDS, MAGD, AGD spokesperson and expert on alternative medicine. “Also, increasing vitamins and other herbs, such as Vitamin C and zinc, can help treat canker sores because they help to regenerate tissue cells,” Dr. Shapira adds.

Common causes of canker sores:

  • Local trauma and stress
  • Diet and food allergies
  • Hormonal changes
  • Use of certain medications

Common treatments of canker sores:

  • Antimicrobial mouthwashes
  • Local painkillers
  • Over-the-counter remedies (oral adhesive patches, liquids and gels)
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The AGD is a professional association of more than 35,000 general dentists dedicated to staying up-to-date in the profession through continuing education. Founded in 1952, the AGD has grown to become the world’s second largest dental association, which is the only association that exclusively represents the needs and interests of general dentists.

More than 786,000 persons are employed directly in the field of general dentistry. A general dentist is the primary care provider for patients of all ages and is responsible for the diagnosis, treatment, management and overall coordination of services related to patients’ oral health needs.