Pneumonia prevention is focused on the pathogens that cause disease, through vaccination and by managing the risks associated with disease development.
The main means of prevention are pneumococcal and influenza vaccination of at-risk people and smoking cessation.[1]Lim WS, Baudouin SV, George RC, et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct;64(suppl 3):iii1-55.
https://thorax.bmj.com/content/64/Suppl_3/iii1.long
http://www.ncbi.nlm.nih.gov/pubmed/19783532?tool=bestpractice.com
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Is there randomized controlled trial evidence to support the use of vaccines for preventing pneumococcal infection in adults?/cca.html?targetUrl=https://cochranelibrary.com/cca/doi/10.1002/cca.388/fullShow me the answer
Pneumococcal and influenza vaccination of at-risk individuals. Public Health England recommends:[61]Public Health England. Immunisation. Aug 2019 [internet publication].
https://www.gov.uk/government/collections/immunisation
Pneumococcal vaccination
Adults aged 65 or over and at-risk groups aged 2 years or over: a single dose of 23-valent pneumococcal polysaccharide vaccine (PPV23). At-risk groups are those with:[62]Public Health England. Pneumococcal: the green book, chapter 25. Jan 2018 [internet publication].
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/674074/GB_Chapter_25_Pneumococcal_V7_0.pdf
Asplenia or dysfunction of the spleen
Chronic respiratory, heart, kidney, or liver disease
Diabetes
Immunosuppression
Cochlear implants
Cerebrospinal fluid leaks
Occupational risk.
At-risk patients should be offered immunisation at every opportunity (for example, when immunising against influenza or at routine consultations), and especially at discharge from hospital.[62]Public Health England. Pneumococcal: the green book, chapter 25. Jan 2018 [internet publication].
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/674074/GB_Chapter_25_Pneumococcal_V7_0.pdf
Influenza vaccination
Adults aged 65 or over, people aged 6 months or over who are in at-risk groups, and children aged 2 to 17 who are not in at-risk groups who are part of the phased vaccination roll-out in the UK: annual influenza vaccine with an age-appropriate formulation, provided they do not have a contraindication. At risk groups are pregnant women and those with:[63]Public Health England. Influenza: the green book, chapter 19. Apr 2019 [internet publication].
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/796886/GreenBook_Chapter_19_Influenza_April_2019.pdf
Chronic respiratory, heart, kidney, liver, or neurological disease
Diabetes
Immunosuppression
Asplenia or dysfunction of the spleen
Class III obesity (BMI ≥40).
Further information on vaccines, vaccination procedures, special patient populations, and current vaccination schedules in the UK can be found in the ‘green book’[62]Public Health England. Pneumococcal: the green book, chapter 25. Jan 2018 [internet publication].
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/674074/GB_Chapter_25_Pneumococcal_V7_0.pdf
[63]Public Health England. Influenza: the green book, chapter 19. Apr 2019 [internet publication].
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/796886/GreenBook_Chapter_19_Influenza_April_2019.pdf
Public Health England: immunisation against infectious disease – the 'green book'
external link opens in a new window and the latest Public Health England vaccination schedule.[61]Public Health England. Immunisation. Aug 2019 [internet publication].
https://www.gov.uk/government/collections/immunisation
Public Health England: complete routine immunisation schedule
external link opens in a new window
Vaccination schedules vary by location; consult local guidance for recommendations.
Smoking cessation
Smoking cessation is important for all patients, but particularly for those at risk of pneumonia and influenza. Offer advice according to national smoking cessation guidelines.[1]Lim WS, Baudouin SV, George RC, et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct;64(suppl 3):iii1-55.
https://thorax.bmj.com/content/64/Suppl_3/iii1.long
http://www.ncbi.nlm.nih.gov/pubmed/19783532?tool=bestpractice.com
National Institute for Health and Care Excellence: stop smoking interventions and services
external link opens in a new window
Cigarette smoking, both active and passive, is a recognised independent risk factor for CAP.[1]Lim WS, Baudouin SV, George RC, et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct;64(suppl 3):iii1-55.
https://thorax.bmj.com/content/64/Suppl_3/iii1.long
http://www.ncbi.nlm.nih.gov/pubmed/19783532?tool=bestpractice.com
For all patients with CAP who smoke, offer advice according to national smoking cessation guidelines.
National Institute for Health and Care Excellence: stop smoking interventions and services
external link opens in a new window Explain to patients how smoking impairs natural mechanisms for eliminating pathogens and debris.[1]Lim WS, Baudouin SV, George RC, et al; Pneumonia Guidelines Committee of the BTS Standards of Care Committee. British Thoracic Society guidelines for the management of community acquired pneumonia in adults: update 2009. Thorax. 2009 Oct;64(suppl 3):iii1-55.
https://thorax.bmj.com/content/64/Suppl_3/iii1.long
http://www.ncbi.nlm.nih.gov/pubmed/19783532?tool=bestpractice.com