[Outlining of the fundamentals for optimizing the antimicrobial therapy of suppurative-inflammatory diseases].

The inflammatory cascade was proven to be triggered rather by small structures of the bacterial origin, i.e. chemical components of bacterial cells, than by bacteria themselves. Sepsis can be viewed today as a body response to an extreme microbe load caused not so much by the circulation of live microorganisms in the blood but rather by an excessive penetration of structural components and molecules of the microbe origin into the blood. Studies of microorganisms' signal molecules are still at the laboratory research stage, however, it can be forecast today that the above studies are clinically prospective. It is actually in case of infections provoked by opportunistically pathogenic microorganisms that the key task consists not in the elimination of bacteria but in the normalization of the host-microbe relations; the possibility to decipher the conduct of microbes through understanding the molecules' signals will provide a clue to comprehending and regulating such most important etiological-and-pathogenetic mechanisms as adhesions, pathological colonization, metabolic activity, bacterial super-growth etc. The confirmed ability of volatile fatty acids (end-products of anaerobic bacteria) to suppress the inflammatory reaction of macrophages urges further search for microbe metabolites with the anti-inflammatory activity. The gas-chromatography and mass-spectrometry investigations, implemented in the mode of mass-fragment scanning, provide for determining (in the blood and other human fluids) dozens of molecules of the microbe origin, which are not synthesized by human cells but which are typical of certain types of microorganisms. It is suggested to carry on with a number of prospective trends based on using the express-tests or so-called non-cultivative diagnostics; such trends are also related with defining the metabolic activity of microorganisms according to a level of their end-product in the blood serum of patients, and with monitoring the level of the microbe load according to chemical components and signal bacteria in biological fluids etc. Finally, all of them are targeted at optimizing the antibiotic therapy.