Cargando…

Prescribing patterns, indications and adverse events of ibuprofen in children: results from a national survey among Italian pediatricians

BACKGROUND: Despite ibuprofen widely recognized safety profile, an increase of suspected adverse events has been reported in the last decade in parallel with its growing over-the-counter use. The aims of this study were to assess the therapeutic approach to the feverish child and to evaluate the mai...

Descripción completa

Detalles Bibliográficos
Autores principales: Martinelli, Massimo, Quaglietta, Lucia, Banderali, Giuseppe, Ferrara, Pietro, Romano, Claudio, Staiano, Annamaria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8059227/
https://www.ncbi.nlm.nih.gov/pubmed/33883005
http://dx.doi.org/10.1186/s13052-021-01047-y
_version_ 1783681160079998976
author Martinelli, Massimo
Quaglietta, Lucia
Banderali, Giuseppe
Ferrara, Pietro
Romano, Claudio
Staiano, Annamaria
author_facet Martinelli, Massimo
Quaglietta, Lucia
Banderali, Giuseppe
Ferrara, Pietro
Romano, Claudio
Staiano, Annamaria
author_sort Martinelli, Massimo
collection PubMed
description BACKGROUND: Despite ibuprofen widely recognized safety profile, an increase of suspected adverse events has been reported in the last decade in parallel with its growing over-the-counter use. The aims of this study were to assess the therapeutic approach to the feverish child and to evaluate the main indications and the most frequent adverse events related to ibuprofen administration in children. METHODS: A specific questionnaire-form regarding the management of ibuprofen therapy in children was distributed among a sample of pediatricians all over the Italian territory between September and October 2020. An electronic data collection through a specifically designed web-based platform was performed among the participating pediatricians. RESULTS: One-hundred-eighty-one pediatricians completed the survey. In case of fever, 177 (98%) participants prescribe paracetamol, while only 4 (2%) preferred ibuprofen as first choice. One-hundred-twenty-eight pediatricians (71%) administer paracetamol alone, while 53 (29.2%) use the combined/alternating treatment with ibuprofen. Ibuprofen is mostly administered for musculoskeletal pain (30%), upper respiratory tract infection (20%), headache (15%) and post-surgical pain (9%). Sixty-three (35%) out of 181 participating pediatricians reported 191 adverse events during ibuprofen administration. The most common were gastrointestinal (GI), with GI bleeding being reported in 30/191 cases (15.7%), epigastric pain in 29/191 (15.1%), non-specified abdominal pain in 22/191 (11.1%) and nausea/vomiting in 21/191 (11%). Severe adverse events including kidney damage (3.1%), complicated infections (0.5%), pneumonia associated empyema (0.5%), soft tissue infection (0.5%) and disseminated intravascular coagulation (0.5%) were also reported. The adverse events led to a hospitalization in 12% of children. In 53/191 cases (28%) the adverse events were related to a wrong dosage or prolonged therapy or errors in frequency of administration. CONCLUSIONS: This survey demonstrate a sufficient awareness of Italian pediatricians regarding ibuprofen-prescribing patterns with the only possible concern related to the relatively high percentage of pediatricians performing a combining/alternating use of paracetamol and ibuprofen. The reported adverse events were mild in most of the cases and often related to errors in dosage, frequency and treatment duration, emphasizing the need for a major caution of both practitioners and patients in their use. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13052-021-01047-y.
format Online
Article
Text
id pubmed-8059227
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-80592272021-04-21 Prescribing patterns, indications and adverse events of ibuprofen in children: results from a national survey among Italian pediatricians Martinelli, Massimo Quaglietta, Lucia Banderali, Giuseppe Ferrara, Pietro Romano, Claudio Staiano, Annamaria Ital J Pediatr Research BACKGROUND: Despite ibuprofen widely recognized safety profile, an increase of suspected adverse events has been reported in the last decade in parallel with its growing over-the-counter use. The aims of this study were to assess the therapeutic approach to the feverish child and to evaluate the main indications and the most frequent adverse events related to ibuprofen administration in children. METHODS: A specific questionnaire-form regarding the management of ibuprofen therapy in children was distributed among a sample of pediatricians all over the Italian territory between September and October 2020. An electronic data collection through a specifically designed web-based platform was performed among the participating pediatricians. RESULTS: One-hundred-eighty-one pediatricians completed the survey. In case of fever, 177 (98%) participants prescribe paracetamol, while only 4 (2%) preferred ibuprofen as first choice. One-hundred-twenty-eight pediatricians (71%) administer paracetamol alone, while 53 (29.2%) use the combined/alternating treatment with ibuprofen. Ibuprofen is mostly administered for musculoskeletal pain (30%), upper respiratory tract infection (20%), headache (15%) and post-surgical pain (9%). Sixty-three (35%) out of 181 participating pediatricians reported 191 adverse events during ibuprofen administration. The most common were gastrointestinal (GI), with GI bleeding being reported in 30/191 cases (15.7%), epigastric pain in 29/191 (15.1%), non-specified abdominal pain in 22/191 (11.1%) and nausea/vomiting in 21/191 (11%). Severe adverse events including kidney damage (3.1%), complicated infections (0.5%), pneumonia associated empyema (0.5%), soft tissue infection (0.5%) and disseminated intravascular coagulation (0.5%) were also reported. The adverse events led to a hospitalization in 12% of children. In 53/191 cases (28%) the adverse events were related to a wrong dosage or prolonged therapy or errors in frequency of administration. CONCLUSIONS: This survey demonstrate a sufficient awareness of Italian pediatricians regarding ibuprofen-prescribing patterns with the only possible concern related to the relatively high percentage of pediatricians performing a combining/alternating use of paracetamol and ibuprofen. The reported adverse events were mild in most of the cases and often related to errors in dosage, frequency and treatment duration, emphasizing the need for a major caution of both practitioners and patients in their use. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13052-021-01047-y. BioMed Central 2021-04-21 /pmc/articles/PMC8059227/ /pubmed/33883005 http://dx.doi.org/10.1186/s13052-021-01047-y Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Martinelli, Massimo
Quaglietta, Lucia
Banderali, Giuseppe
Ferrara, Pietro
Romano, Claudio
Staiano, Annamaria
Prescribing patterns, indications and adverse events of ibuprofen in children: results from a national survey among Italian pediatricians
title Prescribing patterns, indications and adverse events of ibuprofen in children: results from a national survey among Italian pediatricians
title_full Prescribing patterns, indications and adverse events of ibuprofen in children: results from a national survey among Italian pediatricians
title_fullStr Prescribing patterns, indications and adverse events of ibuprofen in children: results from a national survey among Italian pediatricians
title_full_unstemmed Prescribing patterns, indications and adverse events of ibuprofen in children: results from a national survey among Italian pediatricians
title_short Prescribing patterns, indications and adverse events of ibuprofen in children: results from a national survey among Italian pediatricians
title_sort prescribing patterns, indications and adverse events of ibuprofen in children: results from a national survey among italian pediatricians
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8059227/
https://www.ncbi.nlm.nih.gov/pubmed/33883005
http://dx.doi.org/10.1186/s13052-021-01047-y
work_keys_str_mv AT martinellimassimo prescribingpatternsindicationsandadverseeventsofibuprofeninchildrenresultsfromanationalsurveyamongitalianpediatricians
AT quagliettalucia prescribingpatternsindicationsandadverseeventsofibuprofeninchildrenresultsfromanationalsurveyamongitalianpediatricians
AT banderaligiuseppe prescribingpatternsindicationsandadverseeventsofibuprofeninchildrenresultsfromanationalsurveyamongitalianpediatricians
AT ferrarapietro prescribingpatternsindicationsandadverseeventsofibuprofeninchildrenresultsfromanationalsurveyamongitalianpediatricians
AT romanoclaudio prescribingpatternsindicationsandadverseeventsofibuprofeninchildrenresultsfromanationalsurveyamongitalianpediatricians
AT staianoannamaria prescribingpatternsindicationsandadverseeventsofibuprofeninchildrenresultsfromanationalsurveyamongitalianpediatricians