brand logo

Am Fam Physician. 1998;57(10):2346

to the editor: The article by Drs. King and Pippin1 on initial antibiotic therapy in community-acquired pneumonia was a comprehensive review of drug therapy for patients with community-acquired pneumonia on an outpatient and inpatient basis and in younger versus older adults. However, since community-acquired pneumonia is a common infection and is the leading cause of death related to infectious disease, more emphasis could have been placed on the use of pneumococcal vaccination in controlling or preventing pneumococcal pneumonia in elderly and high-risk patients with chronic disease.

Fedson2 showed in case-control studies and indirect cohort studies that pneumococcal vaccination is effective in preventing invasive pneumococcal disease in patients who are older or who are at higher risk. The Office of Technology Assessment has also shown that pneumococcal vaccination is cost-effective in preventing pneumococcal pneumonia in elderly persons.2 The cohort study showed that patients who were discharged after being treated for pneumonia had a 6 to 9 percent probability of readmission with pneumonia within five years and that each such readmission could be prevented by immunizing discharged patients with pneumococcal vaccine. The study also showed that the costs of vaccination would equal approximately one third the costs of hospital care for unvaccinated patients who were discharged and then readmitted with pneumonia; the authors recommend that elderly patients be immunized with pneumococcal vaccine on discharge from the hospital.

Another article by Gable and colleagues3 evaluated the efficacy and cost savings of the pneumococcal pneumonia vaccine in a retrospective cohort study; the investigators concluded that the pneumococcal vaccine is effective in persons who have had pneumonia, persons who are at risk of developing pneumonia, and persons who are over 50 years of age.

Family physicians need to place greater emphasis on giving pneumococcal vaccine to the elderly and others who are at risk for pneumonia.

Email letter submissions to Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors. Letters submitted for publication in AFP must not be submitted to any other publication. Letters may be edited to meet style and space requirements.

This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

Continue Reading

More in AFP

More in PubMed

Copyright © 1998 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.