Intended for healthcare professionals

Rapid response to:

Clinical Review

Treatment of bronchiectasis in adults

BMJ 2007; 335 doi: (Published 22 November 2007) Cite this as: BMJ 2007;335:1089

Rapid Response:

Role of Pneumococcal and Influenza Vaccination in Management of Bronchiectasis

Role of Pneumococcal and Influenza vaccines should not be
underestimated. Bronchiectasis is increasingly recognized as a major
cause of respiratory morbidity especially in developing countries. Even in
affluent countries, bronchiectasis is increasingly seen in some community
subsections (e.g. Aboriginal communities) and occurs as a comorbidity and
disease modifier in respiratory diseases such as chronic obstructive
pulmonary disease (COPD).
Respiratory exacerbations in people with bronchiectasis is associated with
reduced quality of life, accelerated pulmonary decline, hospitalisation
and even death.
Conjugate pneumococcal vaccine is part of the routine infant immunisation
schedule in many countries. Current recommendations for additional
pneumococcal vaccination include children and adults with chronic
suppurative disease. [1]
At present, there is a lack of reliable evidence to support or refute the
routine use of pneumococcal vaccine as routine management in children and
adults with bronchiectasis.

Randomised controlled trials examining the efficacy of this
intervention using various vaccine types in different age groups are

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. [2]

1 Pneumococcal vaccines for children and adults with bronchiectasis.
Chang CC, Singleton RJ, Morris PS, Chang AB. Cochrane Database Syst Rev.
2007 Apr 18;(2):CD006316

2. Influenza vaccine for children and adults with bronchiectasis.
Chang CC, Morris PS, Chang AB. Cochrane Database Syst Rev. 2007 Jul

Competing interests:
None declared

Competing interests: No competing interests

29 November 2007
Robert James
MD Medicine
Akashdeep Singh, Jasveer James
Christian Medical College and Hospital, Ldh, Pb, In