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Influenza vaccine for children and adults with bronchiectasis

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Abstract

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Background

Bronchiectasis is a major cause of respiratory morbidity especially in developing countries. In affluent countries, bronchiectasis is increasingly recognised in certain subsections of communities (e.g. Aboriginal communities) as well as a coexistent disease/comorbidity and disease modifier in respiratory diseases such as COPD (reported rates of 29‐50% in adults). Respiratory exacerbations in people with bronchiectasis are associated with reduced quality of life, accelerated pulmonary decline, hospitalisation and even death. Current recommendations for inactivated influenza vaccination includes adults aged 65 years and over, those in residential care and health care workers and also all adults and children with chronic illness, particularly cardiac and pulmonary diseases.

Objectives

To evaluate the effectiveness of influenza vaccine as routine management in children and adults with bronchiectasis in (a) reducing the severity and frequency of respiratory exacerbations and (b) pulmonary decline

Search methods

The Cochrane Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE and EMBASE databases were searched by the Cochrane Airways Group. Pharmaceutical manufacturers of influenza were also contacted. The latest searches were performed in July 2010.

Selection criteria

All randomised controlled trials with at least one annual influenza vaccine involving children or adults with bronchiectasis.

Data collection and analysis

Results of searches were reviewed against pre‐determined criteria for inclusion. It was planned that two independent reviewers selected, extracted and assessed data for inclusion.

Main results

No eligible trials were identified and thus no data were available for analysis.

Authors' conclusions

There is neither evidence for, nor against, routine annual influenza vaccination for children and adults with bronchiectasis.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

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Influenza vaccine for children and adults with bronchiectasis

In many countries, influenza vaccination is an accepted part of routine immunisation recommendations particularly in persons 65 years and over, those in long‐term care facilities and also adults and children with chronic illnesses including those with bronchiectasis. In this review however, our search for randomised control trials examining the effectiveness of influenza vaccines for people with bronchiectasis revealed no relevant studies. In the absence of evidence, patients' needs should be individualised and national guidelines be adhered to.