Anti-inflammatory, analgesic and antibiotic: what is the difference between these drugs?

The main difference between anti-inflammatory drugs, analgesics and antibiotics is the way they act in the body – which results in different indications. Confusion between classes can also occur with remedies that are used for more than one purpose or even together.

MinhaVida talked to neurosurgeon Carlos Roberto Massela Junior to clarify the differences between analgesics, anti-inflammatories and antibiotics and when each is indicated. Check out!

How does the anti-inflammatory work?

Anti-inflammatories are drugs capable of prevent or lessen an inflammatory reaction caused by an infection or injury. The mechanism of action of anti-inflammatory drugs is the inhibition of prostaglandins, produced by an enzyme called cyclooxygenasereducing vasodilation and edema in the inflamed region.

“If you fight cyclooxygenase using anti-inflammatory drugs, the production of prostaglandins decreases, fighting inflammation, fever and pain”, adds Carlos Roberto.

There are two classes of anti-inflammatory drugs, namely:

• Non-hormonal (NSAIDs): are the drugs most commonly used today, whose mechanism of action is inhibition of cyclooxygenase (COX), which act as mediators of inflammation and influencers on platelet aggregation. The best known include aspirin and ibuprofen;
• Hormones (corticosteroids): are a class of drugs with anti-inflammatory and immunosuppressive action, that is, used to suppress the body’s defense mechanisms. Their use is indicated only for specific clinical conditions, since they cause various metabolic alterations, such as variations in blood sugar, hypertension and loss of potassium. Dexamethasone and prednisolone are examples.

It should be noted that anti-inflammatories also have an antipyretic and analgesic effect, contributing to an improvement in pain in general. Typically, they are indicated for back pain, fever, flu or cold and headache.

Learn more: How does an anti-inflammatory work? Expert explains

How does the antibiotic work?

Antibiotics are natural or synthetic drugs and compounds used for the treatment of bacterial infections. They destroy bacteria or stop their reproduction, making it easier for the body’s defenses to eliminate the microorganisms that cause a certain infectious process.

They are divided into groups or classes according to their basic chemical structure—in this way, each antibiotic is only effective against certain bacteria. Some of the most used ones include:

• Penicillins: are indicated for the treatment of infections such as bronchitis, pneumonia, sinusitis, urinary or vaginal infections, for example. The main antibiotics of the penicillin class are amoxicillin, benzathine penicillin G and ampicillin;
• Tetracyclines: they are bacteriostatic antibiotics, that is, they inhibit bacterial growth, of broad spectrum and very effective against several aerobic and anaerobic bacteria.
• Sulfonamides: are also known as sulfas and are bacteriostatic agents. They were used to treat patients with urinary tract infections and also in HIV carriers who have bacterial infections.
• Macrolides: are bacteriostatic agents used in respiratory infections such as pneumonia, acute bacterial exacerbation of chronic bronchitis, acute sinusitis, otitis media, tonsillitis and pharyngitis.
• Cephalosporins: are generally indicated for the treatment of respiratory tract infections, otitis media, skin infections and urinary tract infections. Some examples include cephalexin and ceftriaxone;
• Aminoglycosides: they are usually indicated for the treatment of skin infections such as ulcers, wounds with pus, boils, eczema or dermatitis.

The use of antibiotics should only be done with medical indication. To choose the most appropriate treatment, doctors calculate which bacteria is causing the infection.

How does the pain reliever work?

Analgesics are drugs used to fight any kind of pain, such as headache, muscle pain and toothache, for example. It works by blocking sensory receptors, preventing the pain signal from being sent to the brain, according to Roberto. “It does not act directly on the inflammatory process, unlike anti-inflammatory drugs, but on pain”, he adds.

There are three main types of analgesics, namely:

• Common: like paracetamol and dipyrone, they are indicated for the treatment of moderate or mild pain, such as headaches, common injuries and menstrual cramps;
• Nonsteroidal anti-inflammatory drugs: are medications that, in addition to fighting inflammation, also have analgesic properties — such as acetylsalicylic acid, ibuprofen and diclofenac. They are usually used to relieve pain caused by some type of injury resulting from inflammation;
• opioids: include synthetic analgesics, such as tramadol, and morphine, a substance derived from opium. They are indicated to treat chronic or severe pain, such as in cases of cancer or after surgery.

Can these drugs be given together?

Analgesic and anti-inflammatory medications can be administered together, provided they are indicated by a specialist. Since the anti-inflammatory may take some time to start working, it may be necessary to use analgesics to relieve the pain caused by the inflammation, accelerating the treatment.

The use of antibiotics and anti-inflammatories can also be combined, in some specific cases — such as a sore throat caused by a bacterial infection, for example. In any case, medical advice is required. Inappropriate use of medications can make the condition worse and cause more serious problems.