[Alveolar macrophages and antibiotics. Review]

Although alveolar macrophages play a key role in pulmonary defence against infections, little is known about interactions of these cells with antibiotics. In vitro, some drugs fail to enter alveolar macrophages readily; in contrast, other antimicrobial agents (clindamycin, erythromycin, ethambutol) are highly concentrated by these cells, as well as josamycin, erythromycin and spiramycin in vivo. Moreover, clindamycin, erythromycin, chloramphenicol, rifampin and pefloxacin lead to an increased phagocytosis by alveolar macrophages, either by compromising bacterial antiphagocytic components or stimulating proper phagocytic activity of the cell. The influence of antibiotics upon mechanisms of microorganisms destruction (production of oxygen metabolites, oxygen independent system), upon regulation of lymphocyte functions (interleukin 1, prostaglandin E2) or other secretory activities (enzymes, modulators of cell activities, various bioactive products) have not been extensively studied and require further investigations.