Mr. Wang often went to the nearby clinic to ask for antimicrobial injection because of chronic nephritis. Half a year has passed, and his hip has suffered a lot, but his condition still has not improved, so he came to the hospital for consultation, and he asked the doctor, “Isn’t antimicrobial agent an anti-inflammatory drug? Why after using penicillin for so long, my nephritis has not improved at all?” Like this Mr. Wang, people who think that as long as the inflammation can be treated with antimicrobial agents do exist, and there are many of them, and some grassroots medical workers also have this vague concept. To properly apply antimicrobials, it is important to first understand what inflammation is and how it differs from what we usually call “inflammation” of an infection.
Inflammation is not all about bacteria
The so-called inflammation, commonly known as “inflammation”, refers to an organ or tissue attacked by some cause, causing tissue congestion, edema and inflammatory cell infiltration or proliferation, the involved organs or tissues undergo local or systemic changes and symptoms. The invasion of bacteria can certainly cause an inflammatory response at the invaded site or even throughout the body, such as lobar pneumonia caused by the invasion of S. pneumoniae into the lung tissue and pyelonephritis caused by the invasion of E. coli into the renal pelvis and renal parenchyma.
In addition to bacteria, other factors can also lead to inflammatory lesions, such as the glomerulonephritis suffered by Mr. Wang is an example. Although nephritis is an inflammation of the kidney, it is not directly caused by bacteria. One type of nephritis is associated with streptococcal infection, such as acute glomerulonephritis, and the rest of nephritis is an immune injury, called immune-mediated inflammation. In addition, there are so many inflammatory conditions that are not directly related to bacteria, such as rheumatoid arthritis, chronic nonspecific colitis, chronic rhinitis, and so on, which will not be listed here.
Inflammation does not always require the use of antimicrobials
Antimicrobial agents are divided into antibacterial and bactericidal agents according to their different characteristics, and their sources can be antibiotics and chemicals, the former from biosynthesis, such as penicillin, gentamicin, etc., the latter is a chemical synthetic agents, such as sulfonamides, furans, quinolones, etc.. They each have hundreds of species, collectively called antibiotics. No matter which type of antimicrobial agent is used, its function is mainly to inhibit the growth of bacteria and kill the disease-causing bacteria, so as to eliminate the cause of the disease, make the inflammation dissipate, and achieve the purpose of the cure. In other words, only diseases caused by bacteria, or lesions related to bacterial invasion are indications for the application of antimicrobials.
Since Mr. Wang’s chronic nephritis is not caused by bacteria, it is not difficult to understand that six months of antimicrobial injections are purely targetless and ineffective. Similarly the abuse of antimicrobials like rheumatoid arthritis and chronic colitis is also undesirable. There are also inflammatory diseases caused by viruses, such as viral myocarditis, the application of antimicrobials is even more unjustified. Therefore, we should know: antimicrobials are not universal anti-inflammatory drugs and are only effective for bacterial inflammation. It is not effective for inflammation caused by immune and viral diseases. Do not use them indiscriminately by hearsay to the point of abuse.
Antibacterial drugs have a target to kill bacteria
All drugs have their own range of action, antibacterial drugs do not have to fight and kill every bacteria. There are many kinds of bacteria, the simplest can be divided into four categories from the morphology and staining characteristics of bacteria: Gram (staining) positive cocci, Gram-negative cocci, Gram-positive bacilli and Gram-negative bacilli. Each drug has a different antibacterial ability, some for cocci and some for bacilli, which is often referred to as the antibacterial spectrum, and each drug has a different antibacterial spectrum. Both for the treatment of inflammation caused by bacteria, but also should be used for the disease, bacteria and use. Otherwise, if you “find the wrong object”, the application of the blank, of course, it is likely to be lucky to “just meet” and achieve results, but more often than not is not the right medicine, futile, and even incur fatal side effects.
Toxic side effects, a heavy topic that can not afford to lose
It can be said responsibly that all drugs must have their side effects, as the saying goes “all drugs have three points of poison”, only depending on the degree of light, heavy, slow and urgent. Antibacterial drugs are no exception, some side effects are quite serious, and even life-threatening. Of course, it is not necessary to talk about the tiger, but it is not wise to treat it like a straw. There are people who are afraid of side effects and refuse the application of antibacterial drugs, to find other ways of treatment, thus delaying treatment, the painful lessons are not isolated; in addition, there are people who abuse or do not recognize the side effects and lead to serious side effects, and even death, the same is not uncommon.
The author has encountered several such cases; one case due to diarrhea self-administered chloramphenicol 3 tablets, three times a day, a total of one day led to a serious reduction in white blood cells, several dangerous, multiple blood transfusions and other aspects of active treatment, to save life from death; another case due to an overdose of penicillin in a private clinic three days after the sudden onset of respiratory depression, after 72 hours of rescue breathing still did not recover, and finally In another case, the patient suddenly developed respiratory depression after three days of overdose of penicillin in a private clinic. There are other toxic side effects that are not serious but are not good for the body after all, which are even more common.
Proper use of antimicrobial agents for pathogenic bacteria
The author used to work in provincial hospitals for nearly 20 years and never considered the problem of difficult pathogenic testing. Later, I moved north and south to work in county hospitals, and even to town health centers. The problem of antimicrobial abuse at the grassroots level is very prominent, the pathogenic bacteria testing, not to mention non-medical personnel, some medical personnel also do not have the concept. In some developed countries have long established “antimicrobial law”, without pathogenic testing and the application of antimicrobial agent is considered illegal. How to properly apply antimicrobial drugs, this is indeed an extremely detailed and complex issue, especially for non-practitioners, it is more difficult to comment on each case.
I would like to suggest the following principles for reference.
① Antibacterial drugs are only effective for bacterial inflammation, do not think that every “inflammation” must be eliminated, listen to the “inflammation” to use;
② If the conditions are best applied in the case of pathogenic testing, such as bacterial culture, according to the drug sensitivity of the most effective antibacterial drugs;
③hearsay drug abuse is potentially more dangerous, delaying the disease and increasing the burden for nothing;
④ Pay attention to the side effects during the medication, when there are symptoms or discomfort that did not exist before, and various skin rashes that did not exist before, it is necessary to stop the medication and promptly go to the doctor to reflect to the doctor;
⑤ In the absence of pathogenic tests, it is important to follow the instructions of the medication to choose the right medication for your condition;
⑥It is best to apply antibacterial drugs under the guidance of a doctor, do not take the initiative and abuse drugs, which can be harmful.