Expert consensus on the role of OM-85 in the management of recurrent respiratory infections: A Delphi study

Abstract

Recurrent infections of upper and lower respiratory tract have an important clinical and economic impact, which can be reduced through appropriate preventive measures, including the use of immunomodulating agents, such as OM-85, which proved to be effective and safe in both adults and children. Although OM-85 can be useful for the prevention of respiratory tract infections, it is still underused in clinical practice. In order to evaluate the level of awareness of the disease burden of recurrent respiratory infections in adults and children and to assess the level of agreement on the prophylactic and therapeutic approach to the disease, including the use of immunomodulants, a Delphi study was performed. A board of six experts in the field of respiratory infections was appointed to elaborate a series of statements covering four main topics (disease, prevention, OM-85, and future strategies), which were thereafter voted by a panel of 30 experts. Results showed that prevention is unanimously recognized as the most important intervention to reduce disease burden, and the use of immunomodulation to improve the effectiveness of vaccination is gaining increasing favor among clinicians. In this respect, OM-85 is recognized as the most studied immunomodulating agent currently available, whose efficacy and safety make it a valuable tool to optimize the management of recurrent respiratory infections in both adults and children. In particular, the combined use of OM-85 and influenza vaccine was recognized as an effective and safe approach to improve the current prevention strategies in order to reduce the burden of recurrent respiratory infections.

ERS International Congress 2022: highlights from the Paediatrics Assembly

“…In a further study regarding the efficacy and tolerability of influenza vaccine in combination with OM-85 [ 17 ] a significant advantage of the combined prevention could be detected compared to the single prevention arm. This finding was additionally supported by the recently online published expert consensus on the role of OM-85 in the management of recurrent respiratory infections [ 18 ].…”

Bacterial immunotherapy is highly effective in reducing recurrent upper respiratory tract infections in children: a prospective observational study

“…Prevention is widely recognized as the most important intervention in reducing the disease burden associated with repeated respiratory tract infections in children. Since the elimination of environmental triggering factors is unfeasible, immunotherapy is considered the most effective preventative strategy [ 30 ]. Our results suggest that the bacterial preparations assessed in the present study were highly effective for this purpose, which could mean significant reductions of the associated clinical [ 1 , 31 ] and financial [ 5 ] burdens, antibiotic prescription and resistance [ 32 , 33 ], and medical complications [ 2 , 34 ].…”

“…Most studies have shown it to be protective against recurrent upper respiratory tract infections [ 6 , 16 , 18 , 39 37 -] despite some conflicting reports [ 40 ], which could be partially explained by the various methods by which the lysates were prepared [ 41 ]. Notwithstanding this considerable amount of favorable evidence concerning the use of this product in upper respiratory tract infections, it is still seldom recommended for ENT infections and in general is not shared among clinicians [ 30 ]. The promising results in our study support the broader recommendation of immunotherapy for the prevention of ENT infections.…”

Management of bronchiolitis and recurrent wheezing in preschoolers

“…In this respect, OM-85 is recognized as the most studied immunomodulatory agent currently available, whose efficacy makes it a valuable tool. 6 In particular, the combined use of OM-85 and vaccination was recognized as an effective approach to improve prevention strategies in order to reduce the burden of recurrent respiratory infections associated with wheezing episodes. 6 …”

“… 6 In particular, the combined use of OM-85 and vaccination was recognized as an effective approach to improve prevention strategies in order to reduce the burden of recurrent respiratory infections associated with wheezing episodes. 6 …”