Ketoprofen, ibuprofen: risks of serious infectious complications


Ketoprofen and ibuprofen, the two best-selling anti-inflammatory drugs that can be taken without warning in case of headache or throat fever, can lead to serious infectious complications, warns the Medicines Agency. According to the results of a survey, "in 18 years, from 2000 to 2018, 337 cases of infectious complications, including 32 deaths have been reported for ibuprofen and 46 cases, including ten deaths with ketoprofen, "says Dr. Philippe Vella, director of analgesic drugs at ANSM.

Ibuprofen (Nurofen, Advil, Upfen Antarene, etc.) and ketoprofen (Profenid, Toprec, Ketum) belong to a family of medicines, non-steroidal anti-inflammatory drugs (NSAIDs), which were already being reported due to serious infectious complications. Hence this research, which had been entrusted by ANSM to the regional pharmacovigilance centers of Tours and Marseille.

Infectious complications

Only the most serious cases in children and adults (often young) without a particular risk factor, such as being immunocompromised, were included in this study. These are serious infections that lead to hospitalizations, sequelae, and death.. They affect the skin and soft tissues, such as "necrotizing fasciitis," an infection caused by a germ (essentially a streptococcus) nicknamed "carnivorous" bacteria, a source of amputation and death.

It can also be septicemia (sepsis), pneumonia, complicated abscess, pleurisy, brain abscess or otolaryngologic infections that reach the thorax (mediastinitis). These contagious complications (mainly due to two bacteria, streptococci or pneumococcus) were observed after a very short treatment period (2 to 3 days), including when combined with antibiotic therapy.

Occurred when ibuprofen or ketoprofen was prescribed or taken by self-medication in fever, but also in many other circumstances: benign skin lesions of inflammatory appearance (local reaction, insect bite …), respiratory manifestations (cough, lung infection …) or otorhinolaryngology (difficulty swallowing, angina, otitis …).

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 indicates having shared those results with its European counterparts. The research also shows that the use of NSAIDs persists in cases of chicken pox while they should be avoided in favor of paracetamol, otherwise risk of serious destruction of bacterial skin.

More generally, paracetamol should be favored in case of pain and / or fever, especially during common infections (angina, nasopharyngitis, otitis, cough, lung infection, skin or chickenpox …), 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 your symptoms worsen, talk to your pharmacist and see 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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