Endotoxin tolerance is defined as a hyporesponsiveness state to a second stimulation with lipopolysaccharide (LPS). This refractory state is primarily associated with an attenuated cytokine production. Whether this down-regulation of cytokine production results in an increased susceptibility to infection remains a matter of controversy. The aim of this study was to investigate the resistance of tolerant mice to a subsequent bacterial infection and the role of bacterial immunomodulator CANTASTIM (CS) in this experimental model. We have shown that the LPS-tolerant mice (intraperitoneally inoculated with LPS Salmonella typhimurium 10 microg/mouse, daily for two days) were protected against a challenge with Pseudomonas aeruginosa (LD 100) administered 24 h later. On the contrary, when the animals were challenged 1 h after the last LPS injection, they did not survive. However if these animals were pre-treated with CS 3 days before LPS treatment, they became resistant to a subsequent bacterial challenge. More interestingly, if the treatment with LPS was substituted with CS (same schedule, route of administration and doses) there was a significant increase in the survival of mice challenged with Pseudomonas aeruginosa after either 1 h or 24 h. In this case, the increase in the rate of survival was correlated with an enhanced production of IL-10 in the peritoneal cavities of CS treated mice as compared to LPS treated mice.