Renal Function After Short-term Ibuprofen Use in Infants and Children

Lesko, Samuel M.; Mitchell, Allen A.

doi:10.1542/peds.100.6.954

Cited by 80 publications

(49 citation statements)

References 11 publications

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“…A total of 385 (1.4%) children were hospitalised and in 112, plasma creatinine was measured and revealed normal levels [8]. Another study by the same authors concluded that ibuprofen had a good renal tolerance if given for a short period of time for antipyretic treatment [7]. However, it should be considered that the local synthesis of prostaglandins is less diminished by antipyretic doses of acetylsalicylic acid compared to NSAIDs.…”

Section: Discussionmentioning

confidence: 99%

Acute renal failure after treatment with non-steroidal anti-inflammatory drugs

Ulinski

Guigonis

Dunan

et al. 2004

European Journal of Pediatrics

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Section: Discussionmentioning

confidence: 99%

Acute renal failure after treatment with non-steroidal anti-inflammatory drugs

Ulinski

Guigonis

Dunan

et al. 2004

European Journal of Pediatrics

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“…The study design and methods of the Boston University Fever Study have been described 4,5 and are only briefly summarized here. The study was a practitioner-based, double-blind clinical trial designed to assess the safety of ibuprofen suspension when used to treat fever in children.…”

Section: Methodsmentioning

confidence: 99%

Asthma Morbidity After the Short-Term Use of Ibuprofen in Children

et al. 2002

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ABSTRACT.Objective. To test the hypothesis that short-term use of ibuprofen increases asthma morbidity in children.Methods. A randomized, double-blind, acetaminophen-controlled clinical trial was conducted. Children who had asthma and a febrile illness were randomly assigned to receive either acetaminophen suspension or ibuprofen suspension for fever control. Rates of hospitalization and outpatient visits for asthma during follow-up were compared by randomization group.Results. A total of 1879 children receiving asthma medications were studied. Rates of hospitalization for asthma did not vary significantly by antipyretic assignment; compared with children who were randomized to acetaminophen, the relative risk for children who were assigned to ibuprofen was 0.63 (95% confidence interval: 0.25-1.6). However, the risk of an outpatient visit for asthma was significantly lower in the ibuprofen group; compared with children who were randomized to acetaminophen, the relative risk for children who were assigned to ibuprofen was 0.56 (95% confidence interval: 0.34 -0.95).Conclusion. Rather than supporting the hypothesis that ibuprofen increases asthma morbidity among children who are not known to be sensitive to aspirin or other nonsteroidal antiinflammatory drugs, these data suggest that compared with acetaminophen, ibuprofen may reduce such risks. Whether the observed difference in morbidity according to treatment group is attributable to increased risk after acetaminophen use or a decrease after ibuprofen cannot be determined. These data provide evidence of the relative safety of ibuprofen use in children with asthma. Pediatrics 2002;109(2). URL: http:// www.pediatrics.org/cgi/content/full/109/2/e20; ibuprofen, NSAIDs, acetaminophen, clinical trial, asthma, bronchospasm.ABBREVIATIONS. NSAIDs, nonsteroidal antiinflammatory drugs; CI, confidence interval.

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“…61,63 However, it is not possible to determine the actual incidence of ibuprofen-related renal insufficiency after short-term use, because it has not been systematically investigated or reported. 64 Children who are at greatest risk of ibuprofen-related renal toxicity are those with dehydration, cardiovascular disease, preexisting renal disease, or the concomitant use of other nephrotoxic agents. 62 Another potential group at risk is infants younger than 6 months because of the possibility of differences in ibuprofen pharmacokinetics and developmental differences in renal function.…”

Section: Ibuprofenmentioning

confidence: 99%

Fever and Antipyretic Use in Children

Sullivan¹,

Farrar²

2011

Pediatrics

363

313

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Fever in a child is one of the most common clinical symptoms managed by pediatricians and other health care providers and a frequent cause of parental concern. Many parents administer antipyretics even when there is minimal or no fever, because they are concerned that the child must maintain a “normal” temperature. Fever, however, is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection. There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications. Thus, the primary goal of treating the febrile child should be to improve the child's overall comfort rather than focus on the normalization of body temperature. When counseling the parents or caregivers of a febrile child, the general well-being of the child, the importance of monitoring activity, observing for signs of serious illness, encouraging appropriate fluid intake, and the safe storage of antipyretics should be emphasized. Current evidence suggests that there is no substantial difference in the safety and effectiveness of acetaminophen and ibuprofen in the care of a generally healthy child with fever. There is evidence that combining these 2 products is more effective than the use of a single agent alone; however, there are concerns that combined treatment may be more complicated and contribute to the unsafe use of these drugs. Pediatricians should also promote patient safety by advocating for simplified formulations, dosing instructions, and dosing devices.

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Renal Function After Short-term Ibuprofen Use in Infants and Children

Cited by 80 publications

References 11 publications

Acute renal failure after treatment with non-steroidal anti-inflammatory drugs

Acute renal failure after treatment with non-steroidal anti-inflammatory drugs

Asthma Morbidity After the Short-Term Use of Ibuprofen in Children

Fever and Antipyretic Use in Children

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