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Enhanced anti-inflammatory efficacy of NSAID–antibiotic combinations in experimental subacute inflammation

Eric Oliviu Coșovanu

The Medical-Surgical Journal, 2025

Abstract

Subacute inflammation represents a transitional stage between acute and chronic inflammatory processes, characterized by fibroblast proliferation and granulomatous tissue development. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac and ketoprofen are widely used to control these processes. Some antibiotics, including cefuroxime and levofloxacin, have also been reported to exhibit secondary anti-inflammatory or immunomodulatory effects. This study investigated the anti-inflammatory efficacy of these agents, administered individually or in combination, using the cotton pellet-induced granuloma model in rats. Materials and methods: Adult Wistar rats were divided into experimental groups receiving intraperitoneal doses of NSAIDs and antibiotics alone or in combination. Granulomatous tissue formation was assessed after subcutaneous implantation of sterile cotton pellets, and the degree of inflammation was evaluated by measuring granuloma development and comparing it across treatment groups. Results: Both NSAIDs produced clear reductions in granuloma formation compared with the untreated control group, confirming their significant anti-inflammatory potential. Levofloxacin showed a moderate inhibitory effect, consistent with its reported cytokine-suppressive and immunomodulatory properties, whereas cefuroxime exhibited minimal influence on inflammatory tissue growth. When combined, NSAIDs and antibiotics produced a greater reduction in granuloma formation than…

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