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Article Reviews & Commentary

Article Reviews by Thomas J. Mancuso, MD, FAAP

Asthma Morbidity After Short-Term use of Ibuprofen in Children.
Lesko SM, Louik C, Venzia RM et al. Pediatrics 2002:109;e20

This paper reports the results of a randomized, double-blind, acetaminophen-controlled trial. The authors assigned children with asthma who also had febrile illnesses to receive either ibuprofen at either 5 or 10 mg/kg/dose or acetaminophen 12 mg/kg/dose for fever control. The groups were compared for rates of hospitalization and outpatient visits for asthma exacerbations. A total of 1879 children were studied over a 28 month period with slightly over 600 children in each group. Children were 6 months to 12 years of age and were followed for 4 weeks. Children who received ibuprofen fared better with their asthma than those who received acetaminophen. Compared to the acetaminophen group the relative risk for hospitalization (0.63) or outpatient visit (0.56) was lower in the ibuprofen group. Although the hospitalization rates for children in the two groups did not differ statistically, the rate for an outpatient visit for asthma was significantly lower in the ibuprofen group compared to the acetaminophen group.


Instead of confirming the safety of acetaminophen for use in children with asthma, the results of this paper suggest that ibuprofen may indeed reduce the risk of asthma exacerbation compared to acetaminophen. At the very least, ibuprofen appears to be at least as safe in these children. Asthma is an inflammatory illness, so it does not take a huge leap to expect that an anti-inflammatory medication will have a beneficial effect on the course of the disease. As is mentioned by the authors, patients with cystic fibrosis have had benefit from ibuprofen treatment. The study was not designed to evaluate the possibility that acetaminophen might worsen asthma and I agree with the authors comments that it cannot be concluded that this is the case based on the results of this investigation. #include ./footer_include.iphtml