Virus-induced secondary bacterial infection: a concise review

Hendaus, Mohamed A; Jomha, Fatima A; Alhammadi, Ahmed H

It has been recommended that treatment or prevention of a viral disease may be a superior method for diminishing 62 It has also been published that live attenuated influenza vaccine is effective in reducing the incidence of all-cause AOM [86] [87] [88] and pneumonia 89 compared to placebo in children. In addition, the intranasal influenza vaccine can reduce OM by 44%. 90 Moreover, studies have shown that a combined influenza/pneumococcal vaccine is efficient in the prevention of OM in children and pneumonia. 91, 92 However, the credit of protection was awarded to the influenza vaccine since studies have shown that pneumococcal vaccine has no benefit in the reduction of AOM. 93, 94 In addition, the pneumococcal polysaccharide vaccine showed no efficacy in the prevention of pneumonia in adults. 95 Treatment of viral infection is anticipated to prevent bacterial superinfections. Currently, the only respiratory virus that is pharmacologically treatable is the influenza viruses (Type A and B). 62 Neuraminidase inhibitors can potentially diminish the morbidity related to influenza. 96 Oseltamivir can reduce the incidence of AOM in preschool children, 97 and the reduction rate can be up to 44%. 98 A meta-analysis review showed that oral oseltamivir reduces the rate of hospitalization by 25% and morbidity by 75%. 99 In addition, its use can reduce the use of antibiotics by up to 50%, 100, 101 The same concept of protection applies to vaccines that prevent against RSV infections. 62 The vaccine available for RSV is palivizumab (MedImmune, Gaithersburg, MD, USA), a humanized monoclonal antibody that perceives the fusion protein of RSV. The other monoclonal antibody that is under clinical trials is motavizumab (MedImmune), which has a higher affinity for RSV fusion protein than palivizumab and can prevent against medically attended lower respiratory tract infection. 102