Objective: To compare the intradermal and percutaneous routes of BCG administration.
Sources of data: A review of the literature published between 1987 and 2002 was carried out in the MEDLINE and Lilacs databases. The following key words were used: BCG vaccine/administration, adverse effects, efficacy, tuberculosis/prevention and control. Some articles published before 1987 were included because of their relevance to the topic.
Summary of the findings: There are no clinical studies comparing the efficacy of intradermal and percutaneous BCG. Percutaneous BCG causes a weaker reaction, however it is also less efficient in stimulating gamma-interferon production by Th1-lymphocytes, which is considered as the best marker of the anti-tuberculin immune response.
Conclusions: In vivo and in vitro studies suggest a better immune response with intradermal BCG. The intradermal method should be recommended for BCG administration.