CHECKUP NEW CHILDREN'S VACCINE IS FAMILY-FRIENDLY.

Byline: - Staff and Wire Services

Vaccinate your child against pneumococcal disease and protect your family as well. That's the message of a new study suggesting that babies who get vaccinated against the pneumococcal germ are less likely to infect their parents and siblings.

There's a catch, however. The children's vaccine, called Prevnar, is in short supply. So, pediatricians are carefully doling it out until the sole U.S. manufacturer - Wyeth Vaccines - can reach full production.

The shortage notwithstanding, the study findings are good news for adults, said study co-author Dr. Henry Shinefield, co-director of the Kaiser Permanente Vaccine Study Center in Oakland. ``Without the possibility of side effects, you get protection,'' he said.

The vaccine protects against contagious pneumococcal infections, which can cause a variety of diseases from ear and sinus infections to pneumonia, meningitis and blood poisoning. Infants and the elderly are most vulnerable, said Dr. Victor Nizet, an associate professor of pediatrics at the University of California, San Diego.

Prevnar appeared on the market in 2000 - a previous version for adults doesn't work in children - and quickly became accepted by pediatricians. It offers protection against the seven most common pneumococcal strains associated with severe illness, Nizet said, and appears to prevent serious complications and, perhaps, ordinary ear infections.

In their new study, funded by Wyeth, Kaiser Permanente researchers examined the medical records of 37,868 vaccinated children. Cases of serious pneumococcal disease dropped by 64 percent among children aged 5 to 19 years old who lived in the households of those vaccinated. Cases fell by 36 percent among adults aged 40 to 59.

KEEP ON THE SUNNY SIDE: Pediatricians who use a positive style of communication are more successful in decreasing the rate of unnecessary antibiotics prescriptions while maintaining patient satisfaction, UCLA researchers have found.

About 235 million doses of antibiotics are given each year, yet only about half are necessary. As a result, bacteria are becoming resistant to antibiotics faster than more powerful drugs can be created. Public health officials have been trying to educate the public that antibiotics are ineffective against viral infections such as colds and flus.

The UCLA researchers videotaped more than 500 doctor visits. Some pediatricians used a positive communication format, where they suggested ways to treat the child's cold symptoms without mentioning antibiotics. Other doctors used a negative format where they ruled out the need for antibiotics.

Parents were more likely to question the treatment plan of the doctors who used the negative format, ruling out antibiotics. When that happened, the pediatricians perceived pressure to prescribe antibiotics. A previous UCLA study had found that pediatricians were 22 percent more likely to provide antibiotics if they believed the parent expected the prescription.

CLEAN LIVING: Surgery to clean out deposits that narrow the main artery to the brain can halve the risk of stroke for people who have no telltale symptoms of impending trouble, a British study finds.

Only 6 percent of people with significant blockage but no symptoms who had the procedure, called carotid endarterectomy, suffered strokes over the next five years, compared to 12 percent of those with the same condition who did not have surgery, said a report in the May 8 issue of The Lancet.

``We think the balance of risk is strongly in favor of surgery,'' said Dr. Alison Halliday, a consultant vascular surgeon at St. George's Medical School in London, who led the Asymptomatic Carotid Surgery Trial.

The new results settle a controversy that arose from a similar but smaller American trial done from 1987 to 1993. Both trials produced essentially similar results, but the British study had nearly twice the number of participants, 3,120 compared to 1,662.

``After that (first) report, we sat down and discussed the results,'' Halliday said. ``We decided that there was not sufficient evidence to know whether the operation would be of value from a European perspective, so we decided to recruit a larger number of patients.''

There was one major difference in the two trials. The American group found a benefit for men but not women, while the Brits found similar benefits for both sexes. One explanation is that the British trial included a large enough group of women to show a benefit.