Recurrent
respiratory tract infections (RRTIs) in adults are the result of an imbalance between lung defense mechanisms, and bacterial burden. Antibacterial treatments can temporarily restore the equilibrium between host and bacterial load, but do not prevent recurrence of
infection. An alternative approach to prevent recurrence of
infection is treatment with an
immunostimulant, which provides immune protection against repeated bacterial and
viral infection. All
immunostimulant products are bacterial in origin: lysates (first generation
immunostimulants), or
bacterial extracts, like bacterial ribosomes, or membrane
proteoglycans. This review highlights the current state of knowledge regarding the use of
immunostimulants in adults with RRTIs, taking the ribosomal
immunostimulant Ribomunyl((R)) as an example. Many studies are available on the mechanism of action and clinical efficacy in prevention of RRTIs in adults treated with
Ribomunyl((R)). The effect of this
immunostimulant on anti-infectious responses is explained by a stimulation of both nonspecific (innate) and specific (adaptive) immunity. In order to obtain a global overview of the therapeutic efficacy of
Ribomunyl((R)) the most pertinent trials were selected from the literature based on adequate patient numbers and good methodology. Results of double-blind placebo-controlled trials using
Ribomunyl((R)) for the treatment of different upper or lower RRTIs have demonstrated a statistically significant reduction in the number of infectious episodes and as a consequence, a decrease in antibacterial consumption, after 3 and 6 months of treatment. The tolerance profile of
Ribomunyl((R)) was good in all studies. Economic evaluations suggest that savings can be made in healthcare expenditure, in patients with recurrent episodes of
infection. It is concluded that
Ribomunyl((R)) is effective in preventing and reducing upper and lower
respiratory tract infections in adults. The product may also have an impact on reducing the development of bacterial resistance, as a result of fewer courses of antibacterials required to treat patients with RRTIs.