Influence of Pneumococcal Conjugate Vaccine on Acute Otitis Media with Severe Middle Ear Inflammation: A Retrospective Multicenter Study.
The Japanese guidelines for acute otitis media in children recommend classifying acute otitis media by age, manifestations and local findings, and also recommend myringotomy for moderate-grade cases with severe local findings, severe-grade cases, and treatment-resistant cases. The heptavalent pneumococcal conjugate vaccine was released in Japan in February 2010. In Hiroshima City, public funding allowing free inoculation with this vaccine was initiated from January 2011, and the number of vaccinated individuals has since increased dramatically. This study investigated changes in the number of myringotomies performed to treat acute otitis media during the 5-year period from January 2008 to December 2012 at two hospitals and five clinics in the Asa Area of Hiroshima City, Japan. A total of 3,165 myringotomies for acute otitis media were performed. The rate of procedures per child-year performed in <5-year-old children decreased by 29.1% in 2011 and by 25.2% in 2012 compared to the mean rate performed in the 3 years prior to the introduction of public funding. A total of 895 myringotomies were performed for 1-year-old infants. The rate of myringotomies per child-year performed for acute otitis media in 1-year-old infants decreased significantly in the 2 years after the introduction of public funding for heptavalent pneumococcal conjugate vaccine compared to all years before introduction (p<0.000001). Our results suggest a benefit of heptavalent pneumococcal conjugate vaccine for acute otitis media in reducing the financial burden of myringotomy. In addition, this vaccine may help prevent acute otitis media with severe middle ear inflammation in 1-year-old infants.
Asa Medical Association, Hiroshima City, Japan; Sugino Pediatric Clinic, Hiroshima City, Japan.
Hirotoshi
H
Sugino
Asa Medical Association, Hiroshima City, Japan; Tsumura ENT Clinic, Hiroshima City, Japan.
Shigeru
S
Tsumura
Asa Medical Association, Hiroshima City, Japan; Department of Otolaryngology, Head and Neck Surgery, Graduate School of Biomedical & Health Sciences, Applied Life Sciences, Hiroshima University, Hiroshima City, Japan; Kunimoto ENT Clinic, Hiroshima City, Japan.
Masaru
M
Kunimoto
Asa Medical Association, Hiroshima City, Japan; Noda ENT Clinic, Hiroshima City, Japan.
Masuhiro
M
Noda
Asa Medical Association, Hiroshima City, Japan; Hiroshima Kyouritsu Hospital, Hiroshima City, Japan.
Daisuke
D
Chikuie
Asa Medical Association, Hiroshima City, Japan; Noda ENT Clinic, Hiroshima City, Japan.
Chieko
C
Noda
Asa Medical Association, Hiroshima City, Japan; Yamashita Clinic, Hiroshima City, Japan.
Mariko
M
Yamashita
Asa Medical Association, Hiroshima City, Japan; Watanabe ENT Clinic, Hiroshima City, Japan.
Hiroshi
H
Watanabe
Asa Medical Association, Hiroshima City, Japan; Hiroshima City Asa Hospital, Hiroshima City, Japan.
Hidemasa
H
Ishii
Asa Medical Association, Hiroshima City, Japan; Tashiro ENT Clinic, Hiroshima City, Japan.
Toru
T
Tashiro
Asa Medical Association, Hiroshima City, Japan; Hiroshima City Asa Hospital, Hiroshima City, Japan.
Kazuhiro
K
Iwata
Asa Medical Association, Hiroshima City, Japan; Department of Otolaryngology, Head and Neck Surgery, Graduate School of Biomedical & Health Sciences, Applied Life Sciences, Hiroshima University, Hiroshima City, Japan; Hiroshima City Asa Hospital, Hiroshima City, Japan.
Takashi
T
Kono
Asa Medical Association, Hiroshima City, Japan; Hiroshima City Asa Hospital, Hiroshima City, Japan.
Kaoru
K
Tsumura
Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima City, Japan.
Takahiro
T
Sumiya
Department of Otolaryngology, Head and Neck Surgery, Graduate School of Biomedical & Health Sciences, Applied Life Sciences, Hiroshima University, Hiroshima City, Japan.
Sachio
S
Takeno
Department of Otolaryngology, Head and Neck Surgery, Graduate School of Biomedical & Health Sciences, Applied Life Sciences, Hiroshima University, Hiroshima City, Japan.
Katsuhiro
K
Hirakawa
D002675:Child, Preschool; D004432:Ear, Middle / Q000276:immunology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D007249:Inflammation / Q000276:immunology / Q000473:pathology / Q000517:prevention & control*; D007564:Japan; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000276:immunology / Q000503:physiopathology / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D018074:Vaccines, Conjugate / Q000008:administration & dosage*
D022242:Pneumococcal Vaccines; D018074:Vaccines, Conjugate