Vaccines for preventing infection with Pseudomonas aeruginosa in people with cystic fibrosis (Cochrane Review)

A substantive amendment to this systematic review was last made on 16 November 1998. Cochrane reviews are regularly checked and updated if necessary.

Background: Chronic pulmonary infection in cystic fibrosis results in progressive lung damage. Once colonisation of the lungs with Pseudomonas aeruginosa occurs, it is almost impossible to eradicate. Potential vaccines, which may prevent infection with P. aeruginosa, are under development and if they provide effective prevention of P. aeruginosa infection they may improve outcome in people with cystic fibrosis.

Objectives: To assess the effectiveness of vaccination against P. aeruginosa in people with cystic fibrosis.

Search strategy: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group trials register which comprises references identified from comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. Date of the most recent search of the Group's trials register: August 2002.

Selection criteria: All randomised or quasi-randomised trials (published or unpublished) comparing P. aeruginosa vaccines (oral, parenteral or intranasal) with control vaccines or no intervention in people with cystic fibrosis.

Data collection and analysis: Both reviewers independently selected trials, assessed trial quality and extracted data.

Main results: Four trials were identified from the initial search. One trial met the inclusion criteria and included a total of 17 vaccinated participants, with follow-up reported to 10 years. Finding only a single trial and lack of information on our predefined outcomes prevented data synthesis and meta-analysis.

Reviewers' conclusions: There is a paucity of randomised controlled trials assessing the effectiveness of vaccination against P. aeruginosa in cystic fibrosis. Increased understanding of modulation of the immune response by vaccination has led to the development of alternative vaccines. We suggest that there is an urgent need for newer vaccines to be evaluated in adequately powered, multicentre randomised controlled trials examining clinically relevant end points in addition to immunological variables. Such a trial should assess effectiveness over several years, and include follow-up of vaccinees who become colonised with P. aeruginosa.

Citation: Keogan MT, Johansen HK. Vaccines for preventing infection with Pseudomonas aeruginosa in people with cystic fibrosis (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update Software.

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This is an abstract of a regularly updated, systematic review prepared and maintained by the Cochrane Collaboration. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).

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File Reference: AB001399.htm