Influenza vaccine for children and adults with bronchiectasis

Background Bronchiectasis is a major cause of respiratory morbidity especially in developing countries. In affluent countries, bronchiectasis is increasingly recognised in certain subsections of communities ( e. g. Aboriginal communities) as well as a coexistent disease/comorbidity and disease modifier in respiratory diseases such as COPD ( reported rates of 29-50% in adults). Respiratory exacerbations in people with bronchiectasis are associated with reduced quality of life, accelerated pulmonary decline, hospitalisation and even death. Current recommendations for inactivated influenza vaccination includes adults aged 65 years and over, those in residential care and health care workers and also all adults and children with chronic illness, particularly cardiac and pulmonary diseases. Objectives To evaluate the effectiveness of influenza vaccine as routine management in children and adults with bronchiectasis in ( a) reducing the severity and frequency of respiratory exacerbations and (b) pulmonary decline Search strategy The Cochrane Register of Controlled Trials ( CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE and EMBASE databases were searched by the Cochrane Airways Group. Pharmaceutical manufacturers of influenza were also contacted. The latest searches were performed in July 2006. Selection criteria All randomised controlled trials with at least one annual influenza vaccine involving children or adults with bronchiectasis. Data collection analysis Results of searches were reviewed against pre-determined criteria for inclusion. It was planned that two independent reviewers selected, extracted and assessed data for inclusion. Main results No eligible trials were identified and thus no data were available for analysis. Authors' conclusions There is neither evidence for, nor against, routine annual influenza vaccination for children and adults with bronchiectasis review however, our search for randomised control trials examining the effectiveness of influenza vaccines for people with bronchiectasis revealed no relevant studies. In the absence of evidence, patients' needs should be individualised and national guidelines be adhered to.