[Modification of phagocytic microbicide function by antifungal agents--measuring luminol enhanced chemoluminescence in full blood].

Fungus infections are becoming more important in surgical intensive medicine, and various preparations are now available to treat them. The goal of our investigations was to determine the influence of the antimycotics in current use on the microbicide phagocytic function by measuring chemiluminescence. To this end the luminol-enhanced chemiluminescence in whole blood samples from a total of 29 healthy donors was measured with a LKB 1251 Luminometer after stimulation with zymosan or a Canadida albicans preparation. We tested the substances amphotericin B, flucytosin (Ancotil), fluconazol (Diflucan) and itraconazol (Sempera), each in three different concentrations within the recommended dose range and compared the results with those in an untreated sample. For the insertions of amphotericin B or intraconazol after zymosan stimulation no significant differences in the measurements were found (50.84 vs 47.99 mV and 46.10 vs 47.89 mV) compared with the blank test. Similar situations revealed by the tests with C. albicans administration (15.21 vs 12.35 mV and 11.16 vs 11.91 mV). However, the tests with flucytosin in the higher concentration range, after stimulation with either zymosan or C. albicans, evidenced a significant reduction in the measurements (34.70 vs 52.74 mV, P<0.005, and 10.98 vs 14.57 mV, P<0.01). The tests with fluconazol showed a decrease of the chemiluminescence exclusively for the highest concentration in the C. albicans group (14.36 vs 17.20 mV, P<0.005). Our results indicate a negative influence of the phagocytes on the oxidative metabolism especially with flucytosin in the higher concentrations. This emphatically confirms demands for exact indications and dosage of antimycotics and their correct administration.