[Percutaneous or intradermal BCG vaccine?].
OBJECTIVE
To compare the intradermal and percutaneous routes of BCG administration.


METHODS
A review of the literature published between 1987 and 2002 was carried out in the MEDLINE and Lilacs databases. The following key words were used: BCG vaccine/administration, adverse effects, efficacy, tuberculosis/prevention and control. Some articles published before 1987 were included because of their relevance to the topic.


RESULTS
There are no clinical studies comparing the efficacy of intradermal and percutaneous BCG. Percutaneous BCG causes a weaker reaction, however it is also less efficient in stimulating gamma-interferon production by Th1-lymphocytes, which is considered as the best marker of the anti-tuberculin immune response.


CONCLUSIONS
In vivo and in vitro studies suggest a better immune response with intradermal BCG. The intradermal method should be recommended for BCG administration.
Bricks
Lucia F
LF
Dep. de Pediatria da FMUSP, and Instituto da Criança do Hospital das Clínicas da Fac. de Medicina da Univ. da São Paulo, Sao Paulo, SP. luciafb@icr.hcnet.usp.br
D000279:Administration, Cutaneous; D001500:BCG Vaccine / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007159:Immunologic Tests; D007271:Injections, Intradermal; D014376:Tuberculosis / Q000276:immunology / Q000517:prevention & control*
D001500:BCG Vaccine