Bacterial lysates (OM-85 BV): a cost-effective proposal in order to contrast antibiotic resistance

Background Chronic Obstructive Pulmonary Disease (COPD) is one of the most frequent pathologies in which antibiotics are used because 50% of the exacerbations are attributable to a bacterial infection. The aims of our study were: i)to perform a meta-analysis on the efficacy of the bacterial lysate OM-85 BV in preventing acute exacerbations in patients with COPD; ii) to evaluate whether this preventive treatment can lead to significant savings for the National Health Service (NHS). Methods A systematic research was conducted in the electronic database MEDLINE (PubMed) in June 2017-July 2020, collecting evidences without time restrictions. Only randomized controlled trials (RCTs) were included. The keywords used were "OM 85 BV AND chronic bronchitis" and "OM 85 BV AND COPD". We realized the cost-effectiveness analysis (CEA) considering the costs for a treatment with OM-8BV, the costs for the treatment of an acute exacerbation and the number of prevented exacerbations. Results 59 publications were found, but the meta-analysis was conducted on 13 studies conducted between 1981 and 2015.OM-85 BV is responsible of a statistically significant reduction in the mean number of COPD exacerbations (p <0.01; WMD -0.86;CI 95% -1.38, -0.34) and in the days of antibiotic therapy (p <0.01; WMD -9.49;CI 95% -11.93, -7.05). The cost-effectiveness ratio with a negative value is in favor to treatment. Conclusions OM-85 BV is effective in reducing exacerbations, and could lead to significant savings for the NHS. Moreover, reducing the number of exacerbations it avoids an over-use of antibiotics and the consequent antibiotic resistance.