Ribosome-component immune modulation of respiratory tract infections in adults.

The standard therapeutic strategy for bacterial episodes (and bacterial superinfections) is the repeated use of antibiotics. Although antibiotics are fast acting and curative, they do not prevent recurrence or complications. The incidence of recurrent respiratory infections and a substantial increase of costs justify preventive measures based on boosting the patients' immune system by immunomodulation using bacterial products, which, in the long term, stimulates immunity and reduces recurrence of infection. This study was designed to review the epidemiological features of respiratory infections and prevention strategies in adults. A narrative review was performed of the relevant literature. Several products of the immune modulator class are available: bacterial lysates, bacterial membrane component by-products, chemically synthesized compounds, and specific bacterial components (ribosome-component immune modulator [RCIM]). The clinical efficacy of the RCIM has specific and nonspecific immunostimulant properties. Efficacy is mainly documented by decreased recurrent episodes of infection and prescription and need for antibiotics. Benefits are generally observed after 3 months of treatment and are maintained for 6 months. Clinical trial evidence is accruing of the efficacy of RCIM in preventing recurrence of upper and lower airway infections or relapses in adults.

Cost effective analysis of ribosome-component immune modulation.

In childhood, recurrent airway infections are the most common cause for medical visits and hospitalizations. Their economic impact is considerable and their treatment accounts for a substantial quota of the health care budget. Despite documented efficacy and safety, ribosomal bacterial vaccine and membrane fraction use is still limited by being prevalently considered for prevention rather than treatment. The objective of this study was to analyze the economic benefit achieved with ribosomal immunotherapy. A review was performed of available literature data on economic parameters. Pharmacoeconomic studies published during the past few years showed how the use of ribosome component immune modulator is capable of reducing expenditure associated with treatment of recurrent respiratory infection and allows achievement of substantial savings in terms of cost, time, and loss of productivity. The initial cost of prevention in patients suffering from chronic respiratory infections is offset by a subsequent saving arising from less recurrence of disease. Direct management costs such as therapy courses, medical visits, medical exams, hospitalizations, etc., and indirect costs such as absence from school and work are not routinely considered by primary care physicians.