Improved phagocyte response by co-amoxiclav in renal transplant recipients

Background. Infectious diseases are a major source of morbidity and mortali ty for immunosuppressed transplant recipients and the antimicrobial chemoth erapy can be often less effective in these individuals, because the contrib ution of underlying host defenses is absent. Methods. The influence of co-amoxiclav on the functions of polymorphonuclea r granulocytes (PMNs) from renal transplant recipients were investigated. Results, PMNs from renal transplant recipients showed a diminished phagocyt ic activity with reduced phagocytosis and bactericidal activity against int racellular Klebsiella pneumoniae, compared to that seen with PMNs from heal thy subjects. Co-amoxiclav significantly elicited the functions of PMNs fro m uremic patients, resulting in an increased percentage of ingested klebsie llae and in a higher bactericidal effect (98-99%), compared with the drug-f ree control system. When PMNs were collected from renal transplant recipien ts treated with co-amoxiclav a significant high increase in both phagocytos is and killing activity were detected, showing the co-amoxiclav capability of "restoring" even in vivo the depressed primary functions of PMNs. Conclusions. The interesting beneficial properties of co-amoxiclav, which r esult in restoring the phagocyte-dependent response in renal transplant pat ients both in vitro and in vivo, may make this drug more suitable for the t reatment of infections in patients with defects of phagocyte functions.