Ibuprofen: eficacitate şi siguranţă pentru pacientul pediatric

Ibuprofen is the main nonsteroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic effect recommended in children, in case of a variety of illnesses, including inflam­mation, mild pain and fever. Its efficacy was proven by many clinical studies and its safety profile makes possible its administration from 3 months of age. Present in protocols, very known in medical world and for wide public, it still requires some statements in order not to forget that, despite its efficiency and safety, some rules of administration are needed, concerning the dosage, indications and especially contraindications. The substance has many forms of presentation, from systemic ones (oral, suppositories, injections) to topic, with a solid documented effect and safety. The pharmacokinetics of ibuprofen was widely assessed both in adults and pediatric patients, thus one can tell that there are no major differences concerning its effects in children over 3 months and in adults. The only recommended antipyretics in fever are acetaminophen and ibuprofen, the studies showing that the latter has proven its rapid action (15 minutes), has an 8-hour duration effect (2 hours more than acetaminophen), decreases malign fever (over 39.2°C) more efficiently and also acts rapidly to al­le­viate the discomfort due to increased body temperature in the first 24 hours. Some actual statements break the old hypothesis involving ibuprofen in bronchospasm oc­cur­rence. The treatment of acute pain in children is based on its severity, but using opioids gives way to adverse reac­tions. Ibuprofen offers a good safety profile and a pro­ven ef­fi­ca­cy in all pediatric illnesses, most frequently seen in oto­rhi­no­la­ryn­go­lo­gy, headache, dental pain, mus­cu­lo­ske­le­tal pain, posttraumatic pain, postoperatively and also in chronic arthritis. Epidemiologic and clinical con­trolled studies have proven that ibuprofen is considered among the NSAIDs with less associated risks for severe gas­tro­­intestinal events, acute renal injury in children with nor­mal renal func­tion, for bronchospasm occurrence in children with asth­ma or for significant liver injury, all these remarking ibu­pro­fen as an analgesic/antipyretic/anti­in­flam­ma­tory drug which proves its efficacy and the favorable profile of tolerability. The essential conditions are to respect the do­sage and indications and to avoid situations which con­tra­in­di­cate the drug (infectious diseases like va­ri­cel­la, severe dehydration and hemostatic disorders).