Lower respiratory tract infection future or investigational therapies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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It is likely that the future treatment of lower respiratory tract infections will consist of new antibiotics aimed at facing the problems associated with the constant emergence of antibiotic resistance. With resistance evolving so rapidly future treatments may include the use of vaccines to prevent these infections. Although a Cochrane systematic review of a polysaccharide pneumococcal vaccine showed that it didn’t reduce pneumonia or related deaths in adults, but it was able to reduce incidence of more specific outcomes such as pneumococcal disease in the elderly. So it is hoped with further developments these will become more effective against pneumonia.

Vaccination of patients with AECB in the autumn months is thought to have a positive effect in reducing the severity and number of exacerbations over winter. The oral vaccine described in this review was able to decrease the carriage or non- typeable Haemophilus influenzae that is a common cause of exacerbations to chronic bronchitis. With good planing and further research these types of vaccines may reduce the burden associated with lower respiratory diseases.

There are few treatments available for viral forms of bronchitis and pneumonia. Respiratory syncytial virus (RSV), the main cause of these in children, could be potentially treated using a new monoclonal antibody (mAb) Motavizumab. In animal trials it reduced antibody titres 100 times lower than the only drug currently available to treat the condition. This holds great promise for future treatments of LRTI.

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