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**Pulmonarom** is a commercial bacterial lysate product containing 6 × 10^8 CFUs each of lysates from *Haemophilus influenzae*, *Staphylococcus aureus*, *Moraxella catarrhalis*, *Klebsiella pneumoniae*, *Streptococcus pneumoniae*, *Streptococcus pyogenes*, *Streptococcus agalactiae*, *Streptococcus dysgalactiae*, and *Streptococcus anginosus*. Marketed in Mexico for over 90 years (registration 13485 SSA IV), it acts as an immunomodulator by promoting maturation of monocyte-derived dendritic cells (moDCs), enhancing HLA-DR expression for antigen presentation, increasing lysosomal activity, upregulating Toll-like receptors (TLR2, TLR3, TLR6, TLR7), and inducing cytokines IL-4, IL-6, IL-8, and MCP-1 without elevating pro-inflammatory IL-1β, TNF-α, or type I IFNs. Administered orally (3 mL ampoule daily for 10 days, repeated after 30 days), it is indicated for prophylaxis of respiratory infections during endemic periods, as an adjuvant to shorten treatment duration, and for nonspecific respiratory irritation from pollutants; it exhibits trained immunity effects potentially improving adaptive responses against respiratory pathogens.[1][2]
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