2023-05-09 08:31:47
On April 27, 2023, the National Medicines Safety Agency (ANSM) warned of the inappropriate use of medicines as common as ibuprofen and the ketoprofen. These non-steroidal anti-inflammatory drugs (NSAIDs), available over the counter without a prescription up to certain doses (25 mg for ketoprofen and 200 mg for ibuprofen), are widely used to relieve pain, for example in ENT infections ( angina, nasopharyngitis, cough, etc.).
However, the Regional Pharmacovigilance Centers reported in March 2023 serious infectious complications, and even deaths, linked to the use of these drugs in certain circumstances. This type of alert is not new. These side effects have been known for a long time. But they occur in a particular context. Since the end of 2022, there has indeed been an upsurge in streptococcal A infections, in particular angina and scarlet fever, pathologies which can worsen very seriously when treated with an NSAID. According to the ANSM, these complications can occur over very short periods of treatment (2 to 3 days) and even when the anti-inflammatory drug is associated with taking an antibiotic.
Why can anti-inflammatories make an infection worse?
Several mechanisms are at play, as explained by Pr Dominique Deplanque, President of the French Society of Pharmacology and Therapeutics: “During a viral or bacterial infection, the body activates a defense system that allows it to fight once morest the attack. The anti-inflammatory drug will block this natural defense mechanism, at the risk of spreading microbes – and particularly bacteria – and exacerbating the infection. These cases are fortunately rare, but the outcome can be dramatic. »
In addition, taking an anti-inflammatory drug will mask warning signs such as redness in the throat, for example, or pain. In this context, the Ansm warns of the risk of “lead to a delay in diagnosis and patient management. »
Finally, you should know that NSAIDs can have side effects, especially at the renal and digestive level. The Medicines Agency recommends using them (when necessary) at the lowest possible dose and over a short period, maximum 5 days to relieve pain.
The special case of angina
Sore throat, difficulty swallowing, fever… tonsillitis can be painful to bear. In most cases, they are of viral origin. More rarely, they are due to a bacterium, the streptococcus Aof which Public Health France has, in recent months, noted an upsurge in France, mainly in children.
To properly treat angina, you need to know its origin. Doctors and pharmacists (since July 1, 2021) have access to tests rapides d’orientation diagnostic very simple. A sample is taken from the throat using a swab. If the test reveals that the angina is bacterial, antibiotic treatment will be prescribed by the doctor. If the angina is viral, antibiotics are of no use.
How to soothe a sore throat?
Whether the angina is viral or bacterial, the sore throat is sometimes intense. However, anti-inflammatory drugs are strongly discouraged since they risk exacerbating the infection. “To calm the pain, it is more reasonable to take paracetamol”, advocates Professor Deplanque. For an adult, it is recommended to start with a dose of 500 milligrams or 1 gram, to be renewed if necessary 4 hours later. In total over a day, do not exceed 3 grams per day.
Another advantage of paracetamol: it helps bring down fever. But here once more, Professor Deplanque calls for moderation: “The temperature remains a physiological defense mechanism that must be respected. There is never any urgency to bring down the fever, unless it is very high (above 39° in an adult, above 38.5° in a child) or if it affects a fragile person: a baby or an elderly person. »
To soothe the throat, you can also make do with a thyme herbal tea with naturally anti-inflammatory properties. It’s risk free. You can also take honey or use certain essential oils.
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