Prehospital NSAIDs use prolong hospitalization in patients with pleuro-pulmonary infection

Kotsiou, Ourania S.; Zarogiannis, Sotirios G.; Gourgoulianis, Konstantinos

doi:10.1016/j.rmed.2016.12.005

Cited by 30 publications

(34 citation statements)

References 32 publications

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“…For example, a database study from France found that patients who had prehospitalization use of nonsteroidal antiinflammatory drugs for symptoms of communityacquired pneumonia developed more severe pneumonia and stayed hospitalized longer than nonusers. 8 Another study examined risk factors for complicated community-acquired infection in children. 9 Both ibuprofen (OR, 3.27; 95% CI, 1.11-9.65) and acetaminophen (OR, 2.68; 95% CI, 1.37-5.23) were identified as risk factors.…”

Section: Evidence On the Safety Of Ibuprofen In Patients With Covid-19mentioning

confidence: 99%

Safety of Ibuprofen in Patients With COVID-19

Sodhi

Etminan

2020

Chest

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Section: Evidence On the Safety Of Ibuprofen In Patients With Covid-19mentioning

confidence: 99%

Safety of Ibuprofen in Patients With COVID-19

Sodhi

Etminan

2020

Chest

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“…Pleural effusion occurs in 15-44% of admitted patients suffering from pneumonia, in which 40% of patients are complicated with parapneumonic effusion or abscess (17,18). For pneumonia treatment, exceeding non-steroidal anti-inflammatory drugs are applied at the early stage, which could easily cause pleural effusion (16,19,20). The empyema in 50% of patients was deprived from pneumonic pleural effusion.…”

Section: Review Articlementioning

confidence: 99%

“…Primary treatment needs to be combined with bacteriology knowledge (5,21), the geographic location of the patient, the infection occurrence place (community or hospital), and the host status for drug selection. At the early stage, antibiotics application would be beneficial to physical rehabilitation and empyema occurrence prevention (19). Subsequent treatment shall refer to the bacteria source and culture results (blood, phlegm and pleural effusion), as well as antibiotics activity in the pleural effusion for adjustment of antibiotics (35).…”

Section: Antibiotic Treatmentmentioning

confidence: 99%

Infectious pleural effusion status and treatment progress

Yang

Zhang

2017

J. Thorac. Dis.

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Pleural cavity infection continuously seriously threatens human health with continuous medical progress. From the perspective of pathophysiology, it can be divided into three stages: exudative stage, fibrin exudation and pus formation stage, and organization stage. Due to the pathogenic bacteria difference of pleural cavity infection and pulmonary infection, it is very important for disease treatment to analyze the bacteria and biochemical characteristics of the infectious pleural effusion. Most prognoses of patients have been relatively good, while for some patients, the complicated parapneumonic effusion or empyema could be evolved. Antibiotic treatment and sufficient drainage are the foundation for this treatment. No evidence can support the routine use of a fibrin agent. However, it has been reported that the plasminogen activator and deoxyribonuclease can be recommended to be applied in the pleural cavity. In case of failure on conservative medical treatment, operative treatment can be applied such as thoracoscopy and pleural decortication.According to the clinical characteristics of these patients, it is a key to research prognosis, as well as early evaluation and stratification, in the future.

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“…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%

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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Prehospital NSAIDs use prolong hospitalization in patients with pleuro-pulmonary infection

Abstract: Our findings highlight the potential complications involved with prehospital use of NSAIDs and especially that prolonged NSAID use which may lead to longer hospitalization duration and more complicated pleural effusions.

Cited by 30 publications

References 32 publications

Safety of Ibuprofen in Patients With COVID-19

Safety of Ibuprofen in Patients With COVID-19

Infectious pleural effusion status and treatment progress

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

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