Adverse drug reactions to nonsteroidal anti-inflammatory drugs, COX-2 inhibitors and paracetamol in a paediatric hospital

摘要: Aims  The use of nonsteroidal anti-inflammatory drugs (NSAIDs) in children has rapidly escalated over the last 5 years Australia. This is primarily as a result availability ibuprofen an over-the-counter preparation. Several recent, significant adverse drug reactions (ADRs) to NSAIDs, at Royal Children's Hospital (RCH) Melbourne, Australia prompted review all RCH reported these agents 5 years. Methods  ADR programme documents both spontaneously ADRs and identified by discharge coding. For this study, aspirin, celecoxib, ibuprofen, indomethacin, naproxen, paracetamol rofecoxib, for previous 5-year period, were retrieved from hospital database. Results  Nineteen reports NSAIDs six paracetamol, patients aged 4 months 22 years (median 10 years) identified. Reactions predominantly rash (n = 10), gastrointestinal (n = 5) respiratory (n = 4) side-effects. These included haematemesis with celecoxib ibuprofen. One patient died severe acute exacerbation asthma following initiation rofecoxib. Conclusion  NSAID exposures are cause morbidity children. Both nonselective newer COX-2 inhibitors associated reactions. overall severity highlights need vigilant surveillance paediatrics, including established agents.