Prevention of New Respiratory Episodes in Children with Recurrent Respiratory Infections: An Expert Consensus Statement from the World Association of Infectious Diseases and Immunological Disorders (WAidid)

Abstract

In healthy infants and young children, the development of respiratory tract infections (RTIs) is extremely common. In this paper, we present an international consensus of the available approaches for the prevention of recurrent RTIs in children, including the atopic/allergic ones as well as those with asthma. Few convincing measures for reducing the frequency and clinical relevance of recurrent respiratory episodes in RTI-prone children have been developed until now. Among the most recently suggested measures, immunotherapy is attractive, but only for OM-85 is there a sufficient number of well-conducted clinical trials confirming efficacy in RTIs prevention with an adequate safety profile. In the case of probiotics, it is not clear which bacteria can offer the best results and which dosage and schedule of administration are the most effective. The problems of dosage and the schedule of administration are not solved also for vitamin D, despite some promising efficacy results. While we wait for new knowledge, the elimination or reduction as much as possible of the environmental factors that favor RTIs, vaccination when available and/or indicated, and the systematic application of the traditional methods for infection prevention, such as hand washing, remain the best measures to prevent recurrent infections in RTI-prone children.

OM-85 Broncho-Vaxom®, a Bacterial Lysate, Reduces SARS-CoV-2 Binding Proteins on Human Bronchial Epithelial Cells

“…OM-85 Broncho-Vaxom ® is a bacterial lysate consisting of cell membrane components obtained from eight different bacteria. Several clinical studies have proven that OM-85 reduced the frequency of viral and bacterial lung infections [ 25 , 26 ]. In this regards, OM-85 induced interferon-β through the toll-like receptor adaptors Trif and MyD88 in bone marrow-derived dendritic cells confirming additional explanations for its efficacy in the treatment of virus-induced airway diseases [ 27 ].…”

Prevention of recurrent respiratory infections

“…The datasheet of the product sold in Italy currently indicates the use of this molecule from the age of 3 upwards [ 23 ] and in subjects with documented immunodeficiency. In patients with hyper-IgE syndromes, atopic subjects or those with a history of allergic reactions, the preparation should be administered prudently and with caution [ 24 ].…”

Effect of immune drugs to treat acute viral nasopharyngitis

“…Применение препаратов β-D-глюканов из высших грибов среди взрослых: пациентов, находящихся на цитостатической терапии, больных диабетом, а также лиц с интенсивной физической нагрузкой (спортсменов-марафонцев, атлетов) также продемонстрировало их клиническую эффективность. В этих группах наблюдалось снижение частоты сезонных простудных заболеваний, а в случае заболевания отмечали более мягкое течение с быстрым выздоровлением [17,26] Мы не обнаружили выраженных различий в динамике изменений симптомов ОНФ в зависимости от пути введения этих препаратов. Возможно, что сходная реакция на вводимые препараты обеспечивается за счет оси «кишечник -легкие», влияющей на иммунитет слизистой ВДП при респираторных заболеваниях через дистальный отдел кишечника [46].…”