The impact of vaccination on rhinosinusitis and otitis media.

Routine childhood vaccination has affected frequency and bacteriology of acute otitis media (AOM) and acute bacterial rhinosinusitis (ABRS). Routine influenza vaccination moderately reduces AOM, and the Haemophilus influenzae type b vaccine likely had a minor role in AOM and ABRS. The conjugated pneumococcal vaccine has drastically reduced invasive pneumococcal disease and caused a moderate decrease in AOM and, likely, ABRS. The vaccine serotypes of Streptococcus pneumoniae have been all but eliminated, but other serotypes have emerged as potential causes of invasive disease. Antibiotic resistance in pneumococcal disease seems to have decreased. A decrease in the overall prevalence of S. pneumoniae may have resulted in an increased incidence of Staphylococcus aureus as a pathogen in AOM and ABRS due to the concept of bacterial interference.