CEFONICID RESTORES THE DEPRESSED ACTIVITIES OF POLYMORPHONUCLEAR CELLS FROM CHRONIC-HEMODIALYSIS PATIENTS AND RENAL-TRANSPLANT RECIPIENTS IN-VITRO

Background. Chronic haemodialysis patients and renal transplant recipi ents are highly susceptible to infection characterized by high morbidi ty and mortality and related to an impairment of the phagocytic respon se. Subjects and methods. In order to elucidate how cefonicid, a cepha losporin with a broad spectrum of activity and once-daily dosage, infl uences this phagocytic response, the effects of the drug upon the func tions of human PMNs from both healthy individuals and immunocompromise d patients were investigated. Results. In vitro, PMNs from haemodialys ed patients and renal transplant recipients showed a diminished phagoc ytic efficiency with reduced phagocytosis and bactericidal activity to wards intracellular Klebsiella pneumoniae when compared with that seen in PMNs from healthy subjects. Cefonicid significantly affected the a ctivity of PMNs from healthy volunteers, resulting in either an increa sed percentage of ingested klebsiellae or a reduced intracellular bact erial load when compared with the control, drug-free system. When cefo nicid was added to PMNs from uraemic patients a pattern similar to tha t observed with phagocytes from healthy subjects was detected: the ant ibiotic was able to 'restore' the depressed primary functions of PMNs, resulting in a significant increase in both phagocytosis and killing activity. Conclusions. Cefonicid, with its several immunoproperties ob served in this study, possesses interesting beneficial properties whic h make it suitable for the treatment of infections in patients with im paired components of the immune system.