Antimicrobials, anti-infectives or antibiotics?

antimicrobial terminology

I am currently reading ‘The Drugs Don’t Work’ by Professor Dame Sally Davies, Dr Jonathan Grant and Professor Mike Catchpole (yes, I know I’m several years late to this particular party). I might do a book review for the blog once I’ve finished it – but an interesting question emerged in the early chapters. The author seem to make a point of referring to ‘antimicrobials’ rather than ‘antibiotics’ in the early part of the book, but later on, antibiotics appears as a common term. Which got me to thinking about what is the most appropriate generic term for what most people would term ‘antibiotics’ (what your GP gives you when you’ve got a snuffle, I mean potentially serious bacterial infection)?

I think most experts agree that ‘antibiotics’ is not a good catch-all term to encompass antibacterials, antivirals, and antifungals. The tight definition of an antibiotic is a substance produced by a micro-organism to kill or inhibit another micro-organism. Plus, antibiotics are closely associated with antibacterials, so doesn’t do a good job of capturing antifungals and antivirals.

There are lots of different ways to approach this, but a working scheme for me also needs to find a home for biocides (chemicals applied for disinfection) and antiseptics (chemicals applied to the skin). So, I’ve come to the scheme above. As you can see, I have made anti-infectives subsidiary to antimicrobials, on a par with biocides and antiseptics.

I’d be interested in hearing what others think about this! Please comment away.

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8 thoughts on “Antimicrobials, anti-infectives or antibiotics?

    • Yes, absolutely. But I think it’s a little too generic, since it also encompasses biocides and antiseptics. So, I think that anti-infective is the best catch-all for substances given to treat infections (antibacterials – which includes antibiotics and synthetic derivatives, antivirals, and antifungals).

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  1. I like this scheme as I always feel unsure about the best names to use when teaching, so list alternative terms, which is boring and confusing for students. But I wonder, how good is the distinction between anti-infectives & antiseptics i.e. surely you can use some antiseptics “to treat infection”?

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  2. Since antibiotics are closely associated with antibacterials, can we just use the latter term directly? I think adding the “anti-infective” layer also looks confusing. Here is what I think (may be naively?) the schema should look like:
    antimicrobial -> biocides, antiseptics, anti-bacterial, anti-viral, anti-fungal

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  3. I agree with your classification – the problem is that antibacterials was a term/claim introduced by the household care industry during the 1990s which – as far as I could see was intended an alternative to disinfectant. The public were beginning to see disinfectants as “too strong” – and because of this they were breeding superbugs! The idea was that antibacterial killed germs in a much gentle way and thus did not cause resistance to develop!! They also believe that antibacterial kill viruses. Educating the medai and public on this would be high impossible

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  4. I also forgot to say – that I always use the term “microbiocides”. The EU has intriouced the Biocidal product regulations – which requires all biocides to be registered. The term biocide under BPR also includes persticides. There is a very passionate European lobby against use of pesticides as you know – so I make sure that I use the term MICRObiocide which ellcits a slightly more rational response!

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  5. I think that ‘antibiotic’ should be at the same level as ‘anti-infective’, but distinct from it, and that both can lead to antibacterials, antivirals and antifungals. Both are anti-infectives, but should be distinguished to recognise the fact that the source of an antibiotic is specific, whereas (as far as I am aware) the source of an anti-infective is not. In addition, anti-parasitics are missing from the scheme and, I think, should be at the same level as antibacterials, antivirals and antifungals.

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