Has the incidence of empyema in Scottish children continued to increase beyond 2005?

Stuart Nath, Matt Thomas, David Spencer, Steve Turner

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)
8 Downloads (Pure)


BACKGROUND: The incidence of empyema increased dramatically in children during the 1990s and early 2000s. We investigated the relationship between changes in the incidence of childhood empyema in Scotland following the 2006 introduction of routine heptavalent conjugate pneumococcal vaccination (PCv-7) and the 2010 introduction of the 13-valent (PCV-13) vaccine.

METHODS: This was a whole-population study of Scottish hospital admissions between 1981 and 2013 using ICD (International Classification of Diseases)-9 and ICD-10 diagnostic codes for empyema. The number of admissions for pneumonia and croup was also captured to give insight into secular trends in admissions with other related and unrelated respiratory presentations.

RESULTS: There were 217 admissions with empyema between 1981 and 2005 (mean incidence 9 cases/million/year) and 323 between 2006 and 2013 (mean incidence 47 cases/million/year), p<0.001. The introduction of conjugate vaccines in 2006 was associated with an overall increase in admissions for empyema of 2.0 (95% CI 1.4 to 2.8) per 100 000 children, however, the incidence rate ratio for empyema admission between 2010 and 2013 was lower relative to 2006-2009 (0.78 (95% CI 0.63 to 0.98)). Secular changes in pneumonia, but not croup, were comparable with those for empyema.

CONCLUSIONS: The incidence of empyema in Scottish children initially rose in children aged 1 to 9 years after the introduction of routine conjugate pneumococcal vaccination, however, empyema incidence has fallen since 2010 when the PCV-13 was introduced.

Original languageEnglish
Pages (from-to)255-258
Number of pages4
JournalArchives of Disease in Childhood
Issue number3
Early online date26 Sept 2014
Publication statusPublished - Mar 2015

Bibliographical note

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.


  • Adolescent
  • Child
  • Child, Preschool
  • Empyema
  • Female
  • Humans
  • Incidence
  • Infant
  • Male
  • Pneumococcal Vaccines
  • Pneumonia, Pneumococcal
  • Scotland


Dive into the research topics of 'Has the incidence of empyema in Scottish children continued to increase beyond 2005?'. Together they form a unique fingerprint.

Cite this