EFFECT OF PROPHYLACTIC ADMINISTRATION OF ANTIPYRETICS IN IMMUNE RESPONSE AFTER PNEUMOCOCCAL CONJUCATE IMMUNIZATION: SYSTEMATIC REVIEW
The aim of this systematic review is to assess the effect of prophylactic use of antipyretics on immune response following conjugate pneumococcal immunization.
A systematic review of literature until June 2019 was conducted in electronic databases of Pubmed and Scopus. Randomized controlled trials were included in the study with no age limitation.
Οut of 3956 citations retrieved, a total of 4 RCTs including 2775 children were included in the review, related to the PCV7 (n=1), PCV10 (n=2) and PCV13 (n=1) vaccines. The prophylactic administration of paracetamol after PCV13 caused a significant decrease in the immune response to pneumococcal serotypes 3,4,5,6B,23F and after PCV10 to serotypes 1,4,5,6B,9V,14,18C. The most significant effect was noted following the immediate administration of antipyretic comparing to administer 4-6 hours later. However, the antibody titers remained above protective levels in 88-100% of the children. No effect on the immunogenicity of the vaccines was detected in the PCV7 study, as well as after ibuprofen administration for all vaccines.
The prophylactic antipyretic administration seems to affect immune response to certain pneumococcal serotypes. More well-designed studies need to be conducted in order to evaluate the clinical significance of this effect.