Respiratory infections and immunostimulants in childhood: an update

Respiratory tract infections are one of the most common childhood illnesses, especially in pre-school children. These infections impose an enormous burden on both the healthcare system (frequent medical consultations and hospitalizations), and on society (parental absenteeism and loss of productivity). Their recurrence still poses a diagnostic challenge in pediatrics due to the difficulty in discriminating between otherwise healthy children and those with more serious underlying pathologies. Moreover, even if viral agents are typically the main cause being responsible of up to 95% of all upper respiratory tract infections, high antibiotic prescription is often reported in clinical practice. It is well known that frequent inappropriate antibiotic use has now led to a significant increase in bacterial resistance. In this context immunostimulants could be a promising preventive approach. Even if the evidence of effectiveness has been debated in the last years, studies focused on one of these compounds (Pidotimod) have recently attempted to better clarify and define its mechanisms of action both in vitro and in vivo and have provided new evidence of efficacy.