[Physiopathologic mechanisms in bacterial infection and antibiotics]

There are basically three mains determinants of effective antimicrobial therapy: pharmacodynamic, pharmaceutical and pharmacokinetic. The pharmacodynamic characteristics of an antibiotic describe its mechanisms of action and its safety profile, that is largely defined in vitro. Its pharmaceutical aspects deal with the formulation of the drug. And the pharmacokinetic determinants deal with those process involved in drug absorption, distribution, metabolism and excretion. The fact that antimicrobial drugs are used in an infected host need to reconsider its possible interactions with the induced non specific and specific host defense reactions. Such inflammatory reactions could modify the pharmacodynamic characteristics, the tissue and cellular distribution of a given antibiotic. Moreover define antibiotics, acting themselves on bacterial structure which are proinflammatory, or cellular compartments involved in the defense mechanisms, such as macrophages, might also interfere indirectly or directly on the expression of the inflammatory reactions associated with bacterial infections. Better knowledges about interelationships between the effects of antimicrobial drugs on the pathophysiological mechanisms induced by bacterial, viral parasitic and fungal infection are warranted.