”Anti-inflammatory” and “antibacterial” are two concepts that do not seem to be the same, but in clinical work, there are not many people who confuse them. How many people have said, “Let me prescribe you some anti-inflammatory drugs, and then write out the names of “cephalosporin”, “levoxyl”, and ornidazole. Here is a table that shows you the difference between “anti-inflammatory” and “antibacterial”! Table 1: Differences between anti-inflammatory drugs and antibacterial drugs Difference 1: Different definitions First of all, the term “anti-inflammatory drugs” is not accurate because there is no such thing as “anti-inflammatory drugs” in pharmacology. The term “anti-inflammatory drug” is actually an anti-inflammatory drug. So by definition, anti-inflammatory drugs are not related to antibacterial drugs. One acts on inflammatory factors and the other on pathogenic microorganisms. If there is a relationship, it is that infectious diseases cause inflammatory reactions that require the combined use of antibacterial drugs and anti-inflammatory drugs. Difference 2: Mechanism of action In terms of mechanism of action, there is no crossover between the mechanism of action of anti-inflammatory drugs and antibacterial drugs. The signs of inflammation are redness, swelling, heat, pain and dysfunction, and NSAIDs can quickly provide antipyretic and analgesic effects. Steroidal anti-inflammatory drugs, namely glucocorticoids, reduce inflammatory exudation, congestion and infiltration in the early stages of inflammation and prevent scar tissue formation in the later stages of inflammation. However, for bacterial infectious diseases, anti-inflammatory drugs are only symptomatic treatment, and the use of the process may reduce the body’s defense ability, while antibacterial drugs are the causative treatment, which is the key to eradicate the disease. Difference 3: Types of drugs From the point of view of the types of drugs included, anti-inflammatory drugs and antibacterial drugs also have no commonality, there is no one anti-inflammatory drug with antibacterial effect, nor an antibacterial drug with anti-inflammatory effect, these are two independent individuals. And the representative drugs of each of them are shown in the following chart: Table 2, Types of anti-inflammatory drugs and representative drugs Table 3, Types of antibacterial drugs and representative drugs Difference 4: Clinical application Inflammation is not a disease, it is a sign, a defense response of the body to inflammatory factors. Infectious inflammation Infectious inflammation is an inflammatory response triggered by the invasion of microorganisms into the organism. It is manifested by increased local blood flow at the invasion site, increased capillary permeability, exudation of tissue fluid and other fluids, and increased leukocyte aggregation. Therefore, anti-inflammatory drugs combined with antibacterial drugs are more effective in treating bacterial infectious inflammation. On the basis of anti-inflammatory drugs to control the inflammatory response, the application of antibacterial drugs can be more effective in removing pathogenic microorganisms (in addition to viruses). And vice versa, the two can be said to play a mutually beneficial role. For example, in severe pneumonia, the administration of anti-inflammatory drugs such as indomethacin can partially reverse hypoxic pulmonary vasoconstriction. And proper use of glucocorticoids such as dexamethasone allows for some expansion of blood volume in those who are critically ill and whose blood pressure is not restored by rehydration therapy. This allows antimicrobial drugs to reach the site of infection for clearance of sensitive organisms smoothly. Non-infectious inflammation For non-infectious inflammation of the body tissue dysfunction, we do not need to use antibacterial drugs, only anti-inflammatory drugs to treat. For example, for arthritis, we can choose ibuprofen to relieve pain and inflammation; for allergic rhinitis, we can choose hormonal nasal sprays to relieve symptoms. Clinicians should be careful about misuse when choosing either antibacterial or anti-inflammatory drugs. For non-infectious inflammation we do not need to use antibacterial drugs. The use of anti-inflammatory drugs should also be used with caution, as their use before the cause is clear may mask the symptoms of the disease and lead to the spread of infection. In summary, anti-inflammatory drugs and antibacterial drugs are two very different kinds of drugs. And the so-called “anti-inflammatory drugs” ≠ “antibacterial drugs”. However, the abuse of antibacterial drugs has become a major public health problem in China. According to the 2010 China Household Medicine Box Survey, 75.4% of Chinese people take antibacterial drugs when they have inflammation or a cold or fever. This may be partly due to the public’s misunderstanding of this “anti-inflammatory drug” which has no clear medical concept. Some doctors use anti-inflammatory drugs as a synonym for antibacterial drugs in order to communicate better with their patients, and this misunderstanding is getting deeper and deeper. As medical professionals, in addition to saving lives and helping patients, they should also provide the public with correct explanations to avoid confusion between these two concepts and the abuse of antibacterial drugs.