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Nonsteroidal Anti-Inflammatory Drug without Antibiotics for Acute Viral Infection Increases the Empyema Risk in Children: A Matched Case-Control Study
- Source :
- The Journal of Pediatrics. 175:47-53.e3
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Objective To investigate the risk factors of empyema after acute viral infection and to clarify the hypothesized association(s) between empyema and some viruses and/or the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Study design A case-control study was conducted in 15 centers. Cases and controls were enrolled for a source population of children 3-15 years of age with acute viral infections between 2006 and 2009. Results Among 215 empyemas, 83 cases (children with empyema and acute viral infection within the 15 preceding days) were included, and 83 controls (children with acute viral infection) were matched to cases. Considering the intake of any drug within 72 hours after acute viral infection onset and at least 6 consecutive days of antibiotic use and at least 1 day of NSAIDs exposure, the multivariable analysis retained an increased risk of empyema associated with NSAIDs exposure (aOR 2.79, 95% CI 1.4-5.58, P = .004), and a decreased risk associated with antibiotic use (aOR 0.32, 95% CI 0.11-0.97, P = .04). The risk of empyema associated with NSAIDs exposure was greater for children not prescribed an antibiotic and antibiotic intake diminished that risk for children given NSAIDs. Conclusions NSAIDs use during acute viral infection is associated with an increased risk of empyema in children, and antibiotics are associated with a decreased risk. The presence of antibiotic-NSAIDs interaction with this risk is suggested. These findings suggest that NSAIDs should not be recommended as a first-line antipyretic treatment during acute viral infections in children.
- Subjects :
- Male
Drug
medicine.medical_specialty
Adolescent
medicine.drug_class
media_common.quotation_subject
Antibiotics
Anti-inflammatory
03 medical and health sciences
0302 clinical medicine
Pharmacotherapy
Risk Factors
030225 pediatrics
Internal medicine
Humans
Medicine
030212 general & internal medicine
Antipyretic
Child
Adverse effect
Empyema, Pleural
media_common
business.industry
Anti-Inflammatory Agents, Non-Steroidal
Case-control study
Infant
medicine.disease
Empyema
Anti-Bacterial Agents
Logistic Models
Virus Diseases
Case-Control Studies
Child, Preschool
Acute Disease
Multivariate Analysis
Pediatrics, Perinatology and Child Health
Immunology
Drug Therapy, Combination
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 00223476
- Volume :
- 175
- Database :
- OpenAIRE
- Journal :
- The Journal of Pediatrics
- Accession number :
- edsair.doi.dedup.....84dce2cc96a6aeae042b84ab206482ef