Immunological perspectives in prevention and treatment of nosocomial pneumonia.

The high mortality associated with current therapeutic approaches to nosocomial pneumonia has motivated consideration of newer immunologic approaches to prevention or therapy of this infection. Serotype specific vaccines, hyperimmune immunoglobulins, and monoclonal antibodies have been developed for certain problematic pathogens. Pseudomonas aeruginosa has been the major focus of this approach, and trials of hyperimmune anti-Ps. aeruginosa globulins for treatment of pneumonia are underway. Broad-spectrum, anti-lipopolysaccharide antibody preparations have also been employed for prophylaxis of nosocomial pneumonia, but to date these trials have not been successful. Finally, anticytokine antibody therapy to reduce infection-initiated inflammatory lung damage is under consideration.