Angina, bronchitis, otitis, sinusitis… Used in an infectious context, anti-inflammatories can represent a real danger to health, including when combined with an antibiotic.
THE return of viruses marks that of the reopening of the medicine cabinet and the taking of medications available to get treatment, without having seen the doctor first. Ibuprofen (Nurofen®, Advil®), ketoprofen (Profenid®, Bi-profenid®), diclofenac (Flector®), naproxen (Apranax®), niflumic acid (Nifluril®), flurbiprofen (Strefen®, Antadys®), aspirin (Aspégic®)… Few people have ever used these medications during an infectious state, especially since some likeIbuprofen or aspirin are available over the counter in pharmacies. They are sometimes prescribed by the doctor during a common bacterial infection such as angina, bronchitis, nasopharyngitis, sinusitis, otitis or dental infection, in combination with an antibiotic. He is so common to see the anti-inflammatory/antibiotic combination on our prescriptions yet it is generally not not recommended. On the one hand because of its lack of medical benefit in common infections, and secondly because the use of an anti-inflammatory in an infectious context can be dangerous or even fatal.
Anti-inflammatories promote the development of bacteria
Due to their mechanism of action in the body by suppressing inflammation, anti-inflammatories decrease normal immune system responses and thus promote the development of bacteria. This is why they can be the cause of serious infections with some severe and sometimes even fatal complications, in adults and children. For example, they can lead to:
- the appearance of abscesses complicated in case of angina,
- severe infections of the skin and soft tissues (dermohypodermatitis, necrotizing fasciitis),
- of septicemia,
- serious pulmonary infections (pneumonia, pleurisy),
- complicated ENT infections (cellulitis, mediastinitis)
- neurological infections (brain abscesses, meningitis).
Thisserious or even fatal infections are often caused by germs of the type Pneumococcus Or Streptococcusand can occur after short treatment periods, including when the anti-inflammatory is combined with an antibiotic. Pharmacoepidemiological studies highlight the possible worsening of Streptococcus infections following the use of NSAIDs, by dissemination of the bacteria and reduction in the effect of the antibiotic.
Anti-inflammatories can delay healing or even worsen the infection
In addition, taking anti-inflammatory drugs in the context of infection (bacterial but also viral, such as varicella in children or shingles in adults) can have the effect of delaying healing or worsening the infection, even with ongoing antibiotic treatment. This risk is all the greater if the choice of antibiotic is not optimal, as in the case where the prescribed antibiotic is not suitable for the germ in question, or in the event of bacterial resistance to the antibiotic.
Finally, when taken from the start of an infection, anti-inflammatories, by reducing inflammation and therefore the associated symptoms (fever, pain, redness), can also mask this infection and lead to a delay or misdiagnosis and support. The infection will be more difficult and longer to treat, with possibly a more serious form. This is why taking an anti-inflammatory during an infection, including in combination with an antibiotic, can represent a real danger to health.
“The association must be exceptional and under medical supervision”
This association must be exceptional and under medical supervision. The use of anti-inflammatories for self-medication in case of cough, skin, ENT, or dental infection can be very dangerous. While waiting to consult a doctor, the only treatment recommended to relieve pain and fever remains paracetamol.
Only very specific situations justify the use of an anti-inflammatory at the same time as an antibiotic, as for example in cases of bacterial infections whose origin is an inflammatory cause, where in this context the anti-inflammatory will then be necessary to eradicate or prevent the infection. The anti-inflammatory/antibiotic combination may also be justified when a significant inflammatory state manifests during a bacterial infection, and on the strict condition that this infection is perfectly controlled (i.e. with a suitable and effective antibiotic against the germ in question). Using an anti-inflammatory with an antibiotic can speed up healing. When taking NSAIDs is necessary, it must be done at the minimum effective dose and on a shortest possible duration. Treatment should be stopped as soon as symptoms disappear.