Systematic review and meta-analysis of the clinical safety and tolerability of ibuprofen compared with paracetamol in paediatric pain and fever

@article{Southey2009SystematicRA,
  title={Systematic review and meta-analysis of the clinical safety and tolerability of ibuprofen compared with paracetamol in paediatric pain and fever},
  author={Elizabeth R Southey and Karla Soares-Weiser and Jos Kleijnen},
  journal={Current Medical Research and Opinion},
  year={2009},
  volume={25},
  pages={2207 - 2222}
}
ABSTRACT Objective: The main aim of this review was to compare the tolerability and safety between ibuprofen and paracetamol when used as anti-pyretic and analgesic agents in children up to 18 years of age. Methods: MEDLINE (1950 to November 2008), EMBASE (1980 to November 2008), The Cochrane Library (2007, Issue 3), ACP Journal Club (1991 to November 2007) and Pascal (1987 to November 2007) were searched for randomised controlled trails (RCTs) (comparing ibuprofen and/or paracetamol with… 
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Prescribing Controversies: An Updated Review and Meta-Analysis on Combined/Alternating Use of Ibuprofen and Paracetamol in Febrile Children

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Combined and alternating acetaminophen and ibuprofen therapy for febrile children.

The Cochrane Review on combining and alternating acetaminophen and ibuprofen for treating fever in children found some evidence that both alternating and combined antipyretic therapy may be more effective at reducing temperatures than monotherapy alone.

A multicenter, randomized, open-label, active-comparator trial to determine the efficacy, safety, and pharmacokinetics of intravenous ibuprofen for treatment of fever in hospitalized pediatric patients

A single 10mg/kg dose of intravenous ibuprofen provided a significant reduction of temperature for febrile pediatric patients compared to those that received 10 mg/kg acetaminophen at 2 h and 4 h post-treatment.
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References

SHOWING 1-10 OF 79 REFERENCES

Efficacy and safety of acetaminophen vs ibuprofen for treating children's pain or fever: a meta-analysis.

In children, single doses of ibuprofen and acetaminophen have similar efficacy for relieving moderate to severe pain, and similar safety as analgesics or antipyretics.

A randomized, double‐blind, multicentre controlled trial of ibuprofen versus acetaminophen and placebo for symptoms of acute otitis media in children

There is no argument to emphasize the utility of nonsteroidal anti‐inflammatory drugs (NSAIDs) in treating the inflammatory signs of the tympanic membrane in otitis and the efficacy of IBU was evidenced on the relief of pain, the symptom that most disturbs the child.

Paracetamol plus ibuprofen for the treatment of fever in children (PITCH): randomised controlled trial

Parents, nurses, pharmacists, and doctors wanting to use medicines to supplement physical measures to maximise the time that children spend without fever should use ibuprofen first and consider the relative benefits and risks of using paracetamol plus ib uprofen over 24 hours.

[Ibuprofen in childhood: evidence-based review of efficacy and safety].

Ib uprofen is not recommended for the treatment of fever or moderate pain during chickenpox or during a disease with a risk of dehydration, until other pharmacoepidemiology studies more accurately quantify the risk of adverse events of ibuprofen in children.

A review of ibuprofen and acetaminophen use in febrile children and the occurrence of asthma-related symptoms.

Paracetamol versus placebo or physical methods for treating fever in children

Trial evidence that paracetamol has a superior antipyretic effect than placebo is inconclusive and there is insufficient evidence to show whether par acetamol influenced the risk of febrile convulsions.

An assessment of the safety of pediatric ibuprofen. A practitioner-based randomized clinical trial.

The risk of hospitalization for gastrointestinal bleeding, renal failure, or anaphylaxis was not increased following short-term use of ibuprofen in children, and data provide no information on the risks of less severe outcomes or the risk of prolonged ib uprofen use.

Comparing efficacy and tolerability of ibuprofen and paracetamol in fever.

Ibuprofen suspension was as effective and well tolerated as paracetamol in treatment of fever in young children and median score for overall efficacy was 'good effect'.

Treating fever in children: paracetamol or ibuprofen?

  • E. Purssell
  • Medicine
    British journal of community nursing
  • 2002
Both drugs are effective antipyretics but the longer action of ibuprofen may make it preferable in some circumstances, and no evidence of difference in short-term adverse effects was observed.

Safety profile of ibuprofen suspension in young children

Overall, ibuprofen exhibited an AE profile similar to acetaminophen in both younger and older children, consistent with the excellent profile observed in children ⩾ 2 yrs.
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