Caution on the use of NSAIDs in children: Recommendations by the Paediatric Working Group of AIFA (Italian Drug Agency)

In the last few years, reports on adverse drug reactions (ADRs) to NSAIDs in paediatric age, especially to ibuprofen and ketoprofen, have remarkably increased. As to the most prescribed ibuprofen, reports (rash, rectal haemorrhage and acute kidney insufficiency) on ADRs have reached 1.7/100,000 paediatric boxes in 2010. Among such ADRs are 6 cases of acute kidney insufficiency (interstitial nephritis). Therefore, the Paediatric Working Group of AIFA gives the following recommendations: do not use antipyretics to treat fever alone, but to treat fever and malaise; choose either paracetamol or ibuprofen, do not use them combined; avoid to use ibuprofen in chickenpox and in dehydration; calculate drug dosage in relation to weight and not to age. There is no published study that has demonstrated the efficacy of NSAIDs in reducing the duration of the symptomatology of respiratory infections; thus, their use, with a presumed curative purpose, is highly advised against in respiratory infections.