Nonsteroidal Anti-Inflammatory Drug without Antibiotics for Acute Viral Infection Increases the Empyema Risk in Children: A Matched Case-Control Study

Bourgeois, M. Le; Ferroni, Agnès; Leruez‐Ville, Marianne; Varon, Emmanuelle; Thumerelle, C.; Brémont, F.; Fayon, Michaël; Delacourt, Christophe; Ligier, Caroline; Watier, Laurence; Guillemot, Didier; Blic, J. de; Deschildre, A.; Lemanac'h, Gaëlle; Bui, Stéphanie; Marguet, Christophe; Lubrano, M.; Labbé, A.; Petit, Isabelle; Faye, Albert; Lorrot, Mathie; Mahdi, Fouad; Dubus, Jean‐Christophe; Bosdure, E.; Pin, Isabelle; Llerena, Cathy; Derelle, J.; Schweitzer, Cyril; Epaud, Ralph; Nathan, Nadia; Reix, Philippe; Wanin, Stéphanie; David, Valérie; Pontbriand, Ulrika de; Brouard, J.; Bessière, Aude; Douay, Caroline; Dupont, Claire; Petit, Claire; Richard, Jean-Romain; Toneatti, Christine; Vibet, Marie-Anne

doi:10.1016/j.jpeds.2016.05.025

Cited by 62 publications

(82 citation statements)

References 39 publications

(46 reference statements)

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“…There is increasing evidence that ibuprofen in case of respiratory infections or pneumonia may facilitate empyema and complicated pneumonia in children [132–135] and adults [136], possibly via modification of neutrophil and alveolar macrophages functionality (chemotaxis, adhesion, aggregation, and degranulation [137]) and the inhibition of prostaglandin synthesis as well as via cover-up effects on subjective symptoms, thereby delaying diagnosis and treatment. This may explain the correlation between increased sales of ibuprofen for children and complicated pneumonia in France [133], although reverse causation is also possible.…”

Section: Discussionmentioning

confidence: 99%

Fever: Views in Anthroposophic Medicine and Their Scientific Validity

Martin

2016

Evidence-Based Complementary and Alternative Medicine

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Objective. To conduct a scoping review to characterize how fever is viewed in anthroposophic medicine (AM) and discuss the scientific validity of these views. Methods. Systematic searches were run in Medline, Embase, CAMbase, and Google Scholar. Material from anthroposophic medical textbooks and articles was also used. Data was extracted and interpreted. Results. Most of the anthroposophic literature on this subject is in the German language. Anthroposophic physicians hold a beneficial view on fever, rarely suppress fever with antipyretics, and often use complementary means of alleviating discomfort. In AM, fever is considered to have the following potential benefits: promoting more complete recovery; preventing infection recurrences and atopic diseases; providing a unique opportunity for caregivers to provide loving care; facilitating individual development and resilience; protecting against cancer and boosting the anticancer effects of mistletoe products. These views are discussed with regard to the available scientific data. Conclusion. AM postulates that fever can be of short-term and long-term benefit in several ways; many of these opinions have become evidence-based (though still often not practiced) while others still need empirical studies to be validated, refuted, or modified.

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Section: Discussionmentioning

confidence: 99%

Fever: Views in Anthroposophic Medicine and Their Scientific Validity

Martin

2016

Evidence-Based Complementary and Alternative Medicine

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“…This included 269 from MEDLINE, 1214 from EMBASE, and 25 studies from COCHRANE CENTRAL database, and 4 studies from searching reference lists. Twelve potential publications that met the inclusion criteria after title and abstract review were identified 3–12, 19, 20 . After full text review, two additional studies with no active comparator (case series) were excluded (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…There were five nested case‐control studies, 4, 5, 7, 8, 12 three cohort studies, 3, 6, 11 and two population‐based case‐control studies 9, 10 (Table ). In total, the studies included 59,724 adults across 5 of the studies (range = 57–59,250) 3, 6, 7, 11, 12 .…”

Section: Resultsmentioning

confidence: 99%

“…However, recent concerns have been raised about the safety of NSAIDS, specifically ibuprofen in patients with lower respiratory tract infections 2 . Observational studies have indicated an increased risk of pneumonia complications associated with NSAIDs in this patient population 3–12 . It has also been hypothesized that NSAIDs, like ibuprofen, can induce proinflammatory cascades that may increase inflammatory response within the lungs, as indicated by greater white blood cell migration, particularly neutrophils 13, 14 …”

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confidence: 99%

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Non‐steroidal Anti‐inflammatory Drugs and the Risk of Pneumonia Complications: A Systematic Review

et al. 2020

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There have been concerns regarding the safety of nonsteroidal antiinflammatory drugs (NSAIDs) in patients with respiratory infections. However, to date, the quality of the evidence has not been systematically assessed. The purpose of this systematic review was to evaluate the role of NSAIDs on pneumonia complications. OVID MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and Google Scholar were searched. Studies that examined pneumonia complications in patients who had taken NSAIDs before onset of symptoms were identified. Quality assessment was conducted using the Risk of Bias in Non‐randomized Studies – of Interventions (ROBINS‐I) assessment tool, which was adapted to include biases that were pertinent to this question. The search strategy identified 1721 potential studies through the 5 primary databases and searching reference lists. Of these, 10 studies met the inclusion criteria, including 5 nested case‐control studies, 2 population‐based case‐control studies, and 3 cohort studies. In total, 59,724 adults were included from 4 of the studies (range = 57–59,250) and 1217 children from 5 studies (range = 148–540). All studies demonstrated a positive association; in adults (odds ratio/risk ratio range = 1.8–8.1) and children (odds ratio/risk ratio range = 1.9–6.8). Studies were limited by moderate or serious risk of confounding bias, exposure misclassification, and protopathic biases and sparse data bias. The results of this review demonstrate that published studies on the effect of NSAIDs use and risk of pneumonia complications are subject to a number of biases. These results should not be extrapolated as evidence of harm for NSAIDs, including ibuprofen, in respiratory ailments but highlight the need for more methodologically robust studies to evaluate this potential relationship.

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“…Möglicherweise ist das auch der Tatsache zu verdanken, dass die Kinder in der Klinik fiebern dürfen, sofern sie nicht darunter leiden. Es gibt eine zunehmende Anzahl an Berichten von Verschleppung und Komplikationen von Lungenentzündungen im Zusammenhang mit Ibuprofen-Gaben [27][28][29][30], mit paralleler Entwicklung zwischen Pleuraempyem Inzidenz und dem Verkauf von Ibuprofen-Saft für Kinder in Frankreich [31]. In einer taiwanesischen Studie wurden Risikofaktoren für die Progression zu Erguss, Empyem oder nekrotisierender Pneumonie untersucht: Alter < 2 Jahre, Pleuraerguss als Aufnahmediagnose, Hb < 10 g / dl, Leukozyten-Zahl > 17.500/ml, Tachypnoe und Dauer bis zur Entfieberung > 3 Tage [32].…”

Section: Verlaufunclassified

Fallbericht: Einsatz von Antibiotika bei Kindern mit Pneumonie

Martin¹

2017

Zeitschrift für Komplementärmedizin

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ZusammenfassungEin 8-jähriger Junge mit Lobärpneumonie wurde stationär mit Anthroposophika, aber ohne Antipyretika oder Antibiotika behandelt. Der Verlauf wurde anhand sonografischer Kontrollen beurteilt. Auch vorangegangene akute Infektionen (Otitis mediaacutaperforata, Pneumonie, Angina tonsillaris) wurden ohne Antibiotika oder Antipyretika behandelt. Zur Behandlung einer Borreliose im Vorfeld erhielt der Junge jedoch Antibiotika. Folgende Punkte werden in dem Fallbericht unter anderem diskutiert: Vitamin-D-Mangel, antibiotische Behandlungen, Fieber und Fiebersenkung, sonografische Diagnosestellung und Verlaufskontrollen. Vor dem Hintergrund der steigenden Rate von Antibiotika-Resistenzen soll dieser Fall zur Diskussion beitragen, wann Antibiotika notwendig sind und wann nicht.

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Nonsteroidal Anti-Inflammatory Drug without Antibiotics for Acute Viral Infection Increases the Empyema Risk in Children: A Matched Case-Control Study

Cited by 62 publications

References 39 publications

Fever: Views in Anthroposophic Medicine and Their Scientific Validity

Fever: Views in Anthroposophic Medicine and Their Scientific Validity

Non‐steroidal Anti‐inflammatory Drugs and the Risk of Pneumonia Complications: A Systematic Review

Fallbericht: Einsatz von Antibiotika bei Kindern mit Pneumonie

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