Chemotherapeutic agents: aspects of their activity on natural mechanisms of defense against infections

This review summarizes the experience gained on interactions between antimicrobial agents and some reactions of the host defense system (adherence, chemotaxis, phagocytosis, microbicidal activity of leukocytes, complement system, antibody production, cell-mediated immunity) and attempts a critical evaluation. The data collected from the literature are often conflicting and there seem to be differences of behavior among derivatives belonging to the same family of antibiotics. Therefore it is quite difficult to draw a correct conclusion from these data. So far it has not been possible to understand the impact that the interference of antibiotics in natural and immunologic reactions of the host defense has on the outcome of chemotherapy, mainly in patients with some degree of immunodepression. In this instance, in fact, the interference with certain immunologic reactions could influence the therapeutic activity of specific antibiotics that are endowed with inhibitory activity. However, so far no controlled study or clear demonstration has shown that antibiotics with different activity on the immunologic reactions can have different efficacy in immunodepressed patients.