NSAIDs in paediatrics: caution with varicella!

Durand, L.; Sachs, P.; Lemaître, C.; Lorrot, Mathie; Bassehila, J.; Bourdon, Olivier; Prot-Labarthe, Sonia

doi:10.1007/s11096-015-0184-2

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…This study indicates a strong association between the use of NSAIDs and severe NSTI, in particular in children with varicella [66]. In conclusion, it is worth being extremely cautious when prescribing ibuprofen to children with varicella because of the increased risk of complications [67]. …”

Section: Tolerability Profiles In Other Conditionsmentioning

confidence: 99%

“…of patientsDisorderTreatmentAdverse events/risk2001Lesko SM [63]224VaricellaIbuprofen alone or with paracetamolGAS infections and necrosis of soft tissues2002Byington CL [64]540Varicella and pneumoniaIbuprofenEmpyema2008Mikaeloff Y [65]140,111VaricellaIbuprofen (and other NSAIDs)Cellulitis, abscess, fasciitis and necrosis2008Souyri C [66]266Varicella and other viral infectionsIbuprofen (and other NSAIDs)Serious necrotising soft-tissue infections2015Durand L [67]3VaricellaNSAIDs, including ibuprofenSuperinfectionPleurisy-pneumonia GAS group A streptococci, NSAIDs non-steroidal anti-inflammatory drugs …”

Section: Tolerability Profiles In Other Conditionsmentioning

confidence: 99%

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Working Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal

Martino

Chiarugi

Boner

et al. 2017

Drugs

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Ibuprofen is the most widely used non-steroidal anti-inflammatory drug (NSAID) for the treatment of inflammation, mild-to-moderate pain and fever in children, and is the only NSAID approved for use in children aged ≥3 months. Its efficacy and safety profile have led to its increasing use in paediatric care, even without medical prescription. However, an increase of suspected adverse reactions to ibuprofen has been noted in concomitance with the raised, often medically unsupervised, consumption of the drug. The purpose of this work was a critical review of the paediatric literature over the last 15 years on side effects and adverse events associated with ibuprofen, in order to highlight circumstances associated with higher risks and to promote safe and appropriate use of this drug. The literature from 2000 to date demonstrates that gastrointestinal events are rare, but (when they occur) include both upper and lower digestive tract lesions. Dehydration plays an important role in triggering renal damage, so ibuprofen should not be given to patients with diarrhoea and vomiting, with or without fever. Likewise, ibuprofen should never be administered to patients who are sensitive to it or to other NSAIDs. It is contraindicated in neonates and in children with wheezing and persistent asthma and/or during varicella. Most of the analysed studies reported adverse events when ibuprofen was being used for fever symptoms or flu-like syndrome. Ibuprofen should not be used as an antipyretic, except in rare cases. Ibuprofen remains the drug of first choice in the treatment of inflammatory pain in children.

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Section: Tolerability Profiles In Other Conditionsmentioning

confidence: 99%

Section: Tolerability Profiles In Other Conditionsmentioning

confidence: 99%

Working Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal

Martino

Chiarugi

Boner

et al. 2017

Drugs

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“…This study indicates a strong association between the use of NSAIDs and severe NSTI, in particular in children with chickenpox [29]. As a consequence of these growing evidences, the use of ibuprofen for symptom control in chickenpox has been progressively abandoned [30,31].…”

Section: Chickenpoxmentioning

confidence: 81%

Serious infectious events and ibuprofen administration in pediatrics: a narrative review in the era of COVID-19 pandemic

2021

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Purpose of review Despite its recognized efficacy and tolerability profile, during the last decade a rise of adverse events following ibuprofen administration in children has been reported, including a possible role in worsening the clinical course of infections. Our aim was to critically evaluate the safety of ibuprofen during the course of pediatric infectious disease in order to promote its appropriate use in children. Recent findings Ibuprofen is associated with severe necrotizing soft tissue infections (NSTI) during chickenpox course. Pre-hospital use of ibuprofen seems to increase the risk of complicated pneumonia in children. Conflicting data have been published in septic children, while ibuprofen in the setting of Cystic Fibrosis (CF) exacerbations is safe and efficacious. No data is yet available for ibuprofen use during COVID-19 course. Summary Ibuprofen should not be recommended for chickenpox management. Due to possible higher risks of complicated pneumonia, we suggest caution on its use in children with respiratory symptoms. While it remains unclear whether ibuprofen may have harmful effects during systemic bacterial infection, its administration is recommended in CF course. Despite the lack of data, it is seems cautious to prefer the use of paracetamol during COVID-19 acute respiratory distress syndrome in children.

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“…Although benign, varicella-associated complications are frequent. Studies have reported potential increase in risks and severe skin associated complications with the use of non-steroidal anti-inflammatory (NSAI), 2 , 3 however, without proved relationship with necrotizing fasciitis. 1 , 6 Exposure to ibuprofen compromises the leukocytosis function, promotes an increase of inflammatory cytokine production, 1 , 2 , 5 and creates a convenient environment for bacterial growth.…”

mentioning

confidence: 99%

“…Apesar de sua benignidade, as complicações da varicela são frequentes. Estudos têm demonstrado potencial aumento do risco de complicações cutâneas graves em associação ao uso de anti-inflamatórios não esteroides (AINEs), 2 , 3 sem, no entanto, relação comprovada com fasceíte necrotizante. 1 , 6 Pensa-se que a exposição ao ibuprofeno compromete a função leucocitária e promove aumento de produção de citocinas inflamatórias, 1 , 2 , 5 criando ambiente propício para crescimento bacteriano.…”

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