Bacillus Calmette Guerin

From Anvita Health Wiki

Contents 1 Indications 2 Contraindications 3 Dosage 4 Drug-interactions 5 Test-interactions 6 Mechanism-of-action 7 More General Terms 8 Additional Terms 9 References

Indications

• intravesical use for carcinoma in situ of the bladder
• BCG vaccine is no longer recommended for adults at high risk for tuberculosis in the USA
• may be considered for infants & children who are skin test- negative & who cannot be given isoniazid prophylaxis who have been exposed or are at high risk for exposure to tuberculosis

Contraindications

• tuberculin-positive individual
• hypersensitivity to BCG or any component
• immunocompromised patients
• burn patients
• fever
• urinary tract infection Warning:

• instillation of BCG into a bleeding mucosa may promote systemic infection

Dosage

• Powder for injection ( lyophilized):

• Connaught strain (TheraCys): 3.4 x 10E8 CFU (27 mg)
• Tice strain (TICE): 1-8 x 10E8 CFU (50 mg, 2 mL) Pharmcokinetics:

• in men but not women, benefits of BCG vaccination lost after 35-40 years Adverse reactions:

• most common (1-10%)

• bladder infection, flu-like syndrome, prostatitis, dysuria, urinary frequency

• uncommon (< 1%)

• skin ulceration, abscess, hematuria, anaphylactic shock (infants), lymphadenitis

Drug-interactions

• immunosupressive agents
• bone marrow suppressants
• anti- tuberculosis drugs

Test-interactions

• causes positive PPD tuberculin skin test

Mechanism-of-action

• BCG vaccination 52% effective against pulmonary tuberculosis [2]
• protect children against [4]

• latent tuberculosis infection
• severe tuberculosis

More General Terms

• vaccine
• antineoplastic agent (chemotherapeutic agent)

Additional Terms

• Mycobacterium tuberculosis (MTB)

References

1. Kaiser Permanente Northern California Regional Drug Formulary, 1998
2. Journal Watch 24(12):99, 2004 a) Aronson NE, Santosham M, Comstock GW, Howard RS, Moulton LH, Rhoades ER, Harrison LH. Long-term efficacy of BCG vaccine in American Indians and Alaska Natives: A 60-year follow-up study. JAMA. 2004 May 5;291(17):2086-91. PMID: [1] b) Dye C. A booster for tuberculosis vaccines. JAMA. 2004 May 5;291(17):2127-8. No abstract available. PMID: [2]
3. Department of Veterans Affairs, VA National Formulary
4. Soyasal A et al, Effect of BCG vaccination on risk of Mycobacteriam tuberculosis infection in children with a household tuberculosis contact. A prospective community-based study. Lancet 366:1443, 2005 PMID: [3]

Bacillus Calmette-Guerin (BCG, TheraCys, TICE, Pacis)