Ibuprofen, ketoprofen: authorities warn about risks of infectious complications



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The two best-selling anti-inflammatory drugs may promote serious infectious complications, warning the Medicines Agency that it asks for "vigilance" and recalls usage tips.

The Medicines Agency (ANSM) on Thursday called for "vigilance" on the consumption of ibuprofen (Nurofen, Advil, Upfen, Antarene, etc.) and ketoprofen (Profenid, Toprec, Ketum), both anti-inflammatory drugs. inflammatory drugs. Sometimes taken without precaution, they could promote serious infectious complications.

According to a survey by the drug agency, "In 18 years, from 2000 to 2018, 337 cases of infectious complications, including 32 deaths were reported for ibuprofen and 46 cases, including ten deaths with ketoprofen," the researcher explains. AFP Dr. Philippe Vella, director of analgesic drugs at ANSM. These two non-steroidal anti-inflammatory drugs (NSAIDs) have been reported for serious infectious complications.

What infections are affected?

This survey, entrusted by ANSM to the regional pharmacovigilance centers of Tours and Marseille, has kept only the most serious cases occurring in children and adults (often young) without any specific risk factors such as being immunocompromised. These cases are serious infections that lead to hospitalizations, sequelae and death.

These infections affect the skin and soft tissues, such as "necrotizing fasciitis", an infection caused by a germ (essentially a strep) called "meat-eating" bacteria, a cause of amputation and death. It can also be septicemia (sepsis), pneumonia, complicated abscess, pleurisy, brain abscess or otolaryngologic infections that reach the thorax (mediastinitis).

Infectious complications occurred when ibuprofen or ketoprofen were prescribed or taken for self-medication in fever, but also in many other circumstances: benign skin lesions with an inflammatory appearance (local reaction, insect bites …), respiratory manifestations (cough, lung infection. ..) or otorhinolaryngology (difficulty swallowing, angina, otitis …). Infections, mainly due to streptococci or pneumococci, were observed after a very short treatment period (2 to 3 days), even when combined with antibiotic therapy.

Paracetamol Privilege

"The results of this research suggest the aggravating role of these NSAIDs in case of infection," especially those due to streptococcus, notes the ANSM, which states that the use of NSAIDs persists in case of varicella while they should be avoided in favor of paracetamol, case Otherwise, there is a risk of severe cutaneous bacterial destruction.

More generally, MSA continues, paracetamol should be favored in case of pain and / or fever, especially during common infections (angina, nasopharyngitis, otitis, cough, lung infection, skin lesions or varicella …), especially in self-medication . These anti-inflammatories should be used "at the lowest effective dose during the shortest period", ie "no more than 3 days in case of fever and 5 days in case of pain".

"If the symptoms worsen, you need to talk to your pharmacist and consult your doctor," advises Dr. Vella. Another rule, do not take at the same time two drugs from this large family of NSAIDs (naproxen, diclofenac …), sold under various names.

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