John A B, Ramlal A, Jackson H, Maude G H, Sharma A W, Serjeant G R
Br Med J (Clin Res Ed). 1984 May 26;288(6430):1567-70. doi: 10.1136/bmj.288.6430.1567.
The efficacy of prophylactic penicillin and of 14 valent pneumococcal vaccine in preventing pneumococcal infection in homozygous sickle cell (SS) disease was investigated in 242 children aged 6 months to 3 years at entry. In the first five years of the trial there were 11 pneumococcal infections in the pneumococcal vaccine treated group, 10 by serotypes present in the vaccine. Type 23 accounted for five of these, and there was evidence of higher infection rates in those given the vaccine before age 1. No pneumococcal isolations occurred in the penicillin group while receiving penicillin, although four isolations occurred within one year of stopping penicillin. Probably the most effective prophylaxis against pneumococcal infection requires penicillin beyond the age of 3. The age at which pneumococcal vaccine should be given must await further data on antibody response and clinical efficacy in these patients.
对242名入组时年龄在6个月至3岁的儿童，研究了预防性使用青霉素和14价肺炎球菌疫苗预防纯合子镰状细胞（SS）病患者发生肺炎球菌感染的效果。在试验的头五年中，肺炎球菌疫苗治疗组发生了11例肺炎球菌感染，其中10例由疫苗中存在的血清型引起。23型占其中5例，有证据表明1岁前接种疫苗的儿童感染率更高。青霉素组在接受青霉素治疗期间未发生肺炎球菌分离，但在停用青霉素后一年内发生了4次分离。可能预防肺炎球菌感染最有效的方法是3岁以后仍使用青霉素。肺炎球菌疫苗的接种年龄必须等待关于这些患者抗体反应和临床疗效的更多数据。
