Serratiopeptidase vs. Lysozyme for Inflammatory Conditions and Bacterial Infections
Based on current evidence, neither serratiopeptidase nor lysozyme can be strongly recommended for treating inflammatory conditions or bacterial infections due to insufficient high-quality evidence supporting their efficacy and safety.
Evidence Assessment
Serratiopeptidase
- Serratiopeptidase is a proteolytic enzyme that has been used for its claimed anti-inflammatory, anti-edemic, and analgesic properties 1
- A systematic review found that evidence supporting serratiopeptidase's use as an anti-inflammatory and analgesic agent is based on clinical studies with poor methodology, small sample sizes, and inadequate reporting of outcomes 1
- There are concerns about serratiopeptidase's fibrinolytic activity potentially causing spread of infection in cases of abscess 2
- Long-term safety data for serratiopeptidase is lacking 1
Lysozyme
- There is insufficient high-quality evidence in the provided materials specifically evaluating lysozyme's efficacy for inflammatory conditions or bacterial infections
Clinical Considerations
Potential Risks of Serratiopeptidase
- Case reports suggest serratiopeptidase may contribute to the spread of infection in cases of abscess due to its fibrinolytic properties 2
- The enzyme's sensitivity to environmental conditions and low cellular penetration limit its effectiveness as a pharmaceutical agent 3
Theoretical Benefits
- Serratiopeptidase theoretically works by breaking down fibrin, thinning inflammatory fluids, and potentially reducing biofilm formation 3, 4
- One animal study suggested serratiopeptidase may enhance antibiotic efficacy against biofilm-forming bacteria in implant-related infections 5
Treatment Recommendations
For inflammatory conditions:
- For rheumatological conditions like rheumatoid arthritis or ankylosing spondylitis, evidence-based guidelines recommend:
- NSAIDs as first-line therapy for symptom management
- Disease-modifying agents (conventional synthetic DMARDs, biologics, or JAK inhibitors) based on disease severity and response to initial therapy 6
For bacterial infections:
- Evidence-based guidelines recommend targeted antimicrobial therapy based on culture and susceptibility testing
- For multidrug-resistant infections, specific antibiotics like ceftazidime-avibactam are recommended based on the pathogen and resistance pattern 6, 7
Conclusion
Neither serratiopeptidase nor lysozyme should be considered first-line therapy for inflammatory conditions or bacterial infections. Clinicians should follow established treatment guidelines using medications with proven efficacy and safety profiles for specific conditions. If considering serratiopeptidase as an adjunctive therapy, be aware of the limited evidence supporting its use and potential risks, particularly in cases of infection.