In the clinic, often when asking about the medical history, we will ask the patient which hospitals they have visited and what medication they have used. Patients usually say they went to a certain hospital for anti-inflammatory injections, and then ask what specific anti-inflammatory injections, the patient will usually say “cephalosporin”, “levofloxacin” and so on. Or as medical professionals, how many of us have ever said, “Come on, I’ll prescribe you some anti-inflammatory drugs, and then write out the names “cephalosporin”, “levofloxacin”, and ornidazole.
”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. The following text is taken from “Clove Garden” to show you the real 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 drug” is not accurate, because there is no such thing as “anti-inflammatory drug” in pharmacology. The term “anti-inflammatory drugs” should be anti-inflammatory drugs.
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 the combination of antibacterial drugs and anti-inflammatory drugs that are needed for the inflammatory response caused by infectious diseases.
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
In terms of the types of drugs included, anti-inflammatory drugs and antibacterial drugs also have no commonality. No anti-inflammatory drug has antibacterial effects, and no antibacterial drug has anti-inflammatory effects, which are two independent individuals.
And the representative drugs of each of the two are shown in the following figure.
Table 2, anti-inflammatory drug types 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 inflammation-causing 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 without difficulty.
Non-infectious inflammation
For non-infectious inflammatory diseases in which the body’s tissues are dysfunctional, we do not need to use antibacterial drugs, but only anti-inflammatory drugs to treat them.
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 need to be careful about abuse 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 Cabinet Survey, 75.4% of Chinese people have inflammatory or cold symptoms.
The 2010 China Household Medicine Box Survey states that 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, we should not only save lives but also give the public correct explanations to avoid the confusion of these two concepts and the abuse of antibacterial drugs.
Rheumatology patients, you should understand the difference between “anti-inflammatory” and “antibacterial”.
In short, “anti-inflammatory” is the specialty of rheumatologists, while “antibacterial” is the winning strategy of respiratory doctors!