Bacterial immunotherapy in bronchial asthma.

In the treatment of bronchospastic states, primary bacterial bronchial asthma and asthmatic bronchitis, one of the most controversial aspects is the use of bacterial vaccines. In general, the treatment of these conditions is symptomatic, neglecting for the most part the existing bacterial allergy. At present, as a result of great advances in the immunotherapy of these disorders, the importance of an allergic response to bacteria in the etiology of these bronchopathies is beyond doubt. The subjects were 120 patients, 59 women and 51 men, with ages ranging from 7 to 73 years. Of this group, 21 were children less than 12 years old and all had a diagnosis of bronchial asthma or asthmatic bronchitis, with or without paranasal sinusitis, and exclusively of bacterial etiology. In order to study and evaluate the effectiveness of immunotherapy, a questionnaire, reproduced in fig. 1 was sent to the patients three years after the beginning of treatment. For this study, only the answers to this questionnaire were considered. Examination of the results shows that in bronchial disorders with bacterial allergy, treatment with bacterial vaccine achieves a 75% success rate. In the small group of children studied (a larger group is currently under investigation), the results are even more satisfactory, reaching 90.47%. It is noteworthy that the immediate reaction to the skin test was positive (++ to ++++) in 83.32% of the cases. Of the greatest importance also is the associated paranasal sinusitis in 83% of the cases, part of a sinobronchopulmonary syndrome which contributes substantially to this state of bacterial allergy. Significant side effects were found in 52.6% of the patients and consisted mainly of slight catarrhal symptoms, apparent at the beginning of treatment. At present, we have no doubt whatsoever that immunotherapy is much more valuable than prolonged symptomatic therapy in the treatment of primary bacterial bronchial asthma.