Vildé J L, Rajagopalan R, Pocidalo J J
INSERM U13, Hôpital Claude-Bernard, Paris.
Pathol Biol (Paris). 1987 Dec;35(10 Pt 2):1418-21.
Direct effects of antimicrobial agents on macrophages functions are not well precised. However, antimicrobials can enhance phagocytosis of bacteria by macrophages in vitro, at subinhibitory concentrations. This enhancement is related to the antibiotic effect. It is dependent of the nature of the antimicrobial agent, of the experimental procedure and some discrepancies appeared in the results. The precise mechanism, effect on the bacterial wall, or on the bacterial protein synthesis is uncertain. The third type of interaction concerns the intracellular penetration and activity of antimicrobial agents within macrophages. In a human monocyte-derived macrophage model, the intracellular growth of Legionella pneumophila was inhibited by erythromycin, rifampicin and fluoroquinolones at concentrations clearly lower than their MICs; doxycycline and cotrimoxazole were inhibitory at concentrations closed to their MICs. Cefoxitin was not inhibitory even at high concentrations despite a low MIC value. This confirms the good intracellular activity of macrolides and fluoroquinolones and the low intracellular activity of beta-lactams.
抗菌剂对巨噬细胞功能的直接影响尚未完全明确。然而，在体外亚抑制浓度下，抗菌剂可增强巨噬细胞对细菌的吞噬作用。这种增强与抗生素效应有关。它取决于抗菌剂的性质、实验程序，并且结果中出现了一些差异。确切的机制，对细菌细胞壁或细菌蛋白质合成的影响尚不确定。第三种相互作用类型涉及抗菌剂在巨噬细胞内的渗透和活性。在人单核细胞衍生的巨噬细胞模型中，红霉素、利福平及氟喹诺酮类药物在浓度明显低于其最低抑菌浓度（MIC）时就能抑制嗜肺军团菌在细胞内的生长；强力霉素和复方新诺明在接近其MIC的浓度时具有抑制作用。尽管头孢西丁的MIC值较低，但即使在高浓度时也没有抑制作用。这证实了大环内酯类和氟喹诺酮类药物具有良好的细胞内活性，而β-内酰胺类药物的细胞内活性较低。
