布洛芬混悬液治疗小儿发热的疗效和安全性研究

发热症状是儿科最为常见的一种症状之一,它能很大程度上影响小儿的正常身心健康,严重者会对小儿中枢神经系统造成较大的危害[1]。因此,引起普遍关注,对其及时进行科学、合理地治疗,有利于病情的缓解以及尽快使患儿恢复至健康的状况。目前,临床上使用较多的是布洛芬混悬液治疗小儿发热症状[2],能够有效地缓解小儿发热症状。本文将我院200例具有发热症状患儿临床资料进行回顾性分析,报告如下。     

布洛芬混悬液与退烧贴治疗小儿发热效果比较探析

目的:就布洛芬混悬液与退烧贴治疗小儿发热的效果进行比较研究.方法:随机选择2015年5月~2016年5月我院接收诊治的100例小儿发热患者,依据治疗手段划分成两个组别,对照组50例接受退烧贴治疗,研究组50例接受布洛芬混悬液治疗,就临床效果进行观察比较.结果:研究组用药30min体温(37.9±0.7)℃、用药1h体温(37.1±0.8)℃,对照组分别为(38.2±0.8)℃、(37.8±0.9)℃,两组差异明显(P<0.05);研究组总有效率96.0%,对照组86.0%,两组差异明显(P<0.05);研究组不良反应发生率6.0%,对照组18.0%,两组差异明显(P<0.05).结论:布洛芬混悬液应用于治疗小儿发热临床效果满意,可显著改善患儿生活质量,具备临床推广价值.     

布洛芬混悬液和安痛定治疗儿童发热的对比观察

高热是小儿急性感染常见的临床表现,以往儿科降温采用滴鼻、解热静脉滴注、肌注安痛定、肌注赖氨匹林等方法,疗效不显著.我科自2008年应用布洛芬混悬液口服退热,观察报道如下.     

布洛芬混悬液与对乙酰氨基酚在小儿高热治疗中的临床疗效观察

目的：观察布洛芬混悬液与对乙酰氨基酚在小儿高热治疗中的临床疗效。方法：本文选取我院2013年8月～2014年8月收治的100例高热患儿，随机分为治疗组和对照组，对照组采用对乙酰氨基酚实施治疗，治疗组采用布洛芬混悬液实施治疗，对比两组临床疗效、治疗前后体温变化情况以及不良反应发生率。结果：治疗后治疗组体温测定为（36.92±0.61）℃，对照组体温测定为（38.03±0.49）℃，两组对比存在显著差异（P<0.05），具有统计学意义。结论：小儿高热采用布洛芬混悬液开展治疗，临床疗效更加显著，对于调整和控制体温有着重要作用，值得临床推广。     

布洛芬混悬液口服与安乃近滴鼻对小儿发热的疗效比较

目的:比较布洛芬混悬液口服与安乃近注射液滴鼻对高热惠儿的退热疗效。方法:对151例体温>38.5℃的急性上呼吸道感染患儿随机分为布洛芬治疗组和安乃近对照组进行比较性研究。结果:治疗组与对照组退热起效时间无显著性差异,但在48 h和72 h退热疗效上有显著性差异。结论:布洛芬组退热疗效好,退热作用持续时间长,不失为儿科临床基本退热药物之一。     

布洛芬混悬液与对乙酰氨基酚在小儿高热治疗中的效果

目的 对比小儿高热治疗中对乙酰氨基酚、布洛芬混悬液的治疗效果。方法 88例小儿高热患儿,通过组内随机性选择的方式分为对照组及观察组,每组44例。对照组采用对乙酰氨基酚治疗,观察组采用布洛芬混悬液治疗。对比两组患儿治疗前后的体温、治疗效果、并发症发生情况。结果 治疗后,观察组患儿的体温(36.32±0.41)℃低于对照组的(37.43±0.28)℃,差异具有统计学意义(P<0.05)。观察组患儿的总有效率97.73%高于对照组的79.55%,差异具有统计学意义(P<0.05)。观察组并发症发生率4.55%低于对照组的18.18%,差异具有统计学意义(P<0.05)。结论 小儿高热患儿采用布洛芬混悬液进行治疗,可以更加有效的保障患儿的治疗效果,促使患儿高热症状尽快得到改善。     

布洛芬混悬液治疗小儿急性上呼吸道感染并高热疗效观察

发热是小儿急性上呼吸道感染的常见症状之一,常引起患儿家长高度紧张和焦虑,而且高热在3岁以下婴幼儿易导致惊厥,频繁发生惊厥影响小儿的智力发育。用布洛芬混悬液(恬倩)治疗小儿急性上呼吸道感染伴高热临床效果显著,现报道如下。1临床资料选择2002年5月～2003年6月门诊就诊的患儿242例,均为急性上呼吸道感染伴高热患儿,随机分成2组,口服恬倩治疗组140例,其中男96例,女44例;对照组102例,男71例,女31例;年龄在1～5岁,病程1～3天,高热(腋温39～41℃)。治疗组与对照组的性别、年龄、病程、发热程度相似,差异无显著性(P>0 05) ,两组具有对比性…     

布洛芬混悬液和对乙酰氨基酚控制儿童气管炎发热的临床观察

发热是多种疾病中最常见的临床症状之一。为探讨对儿童高热安全有效药物，笔者于2008年1月-8月，分别应用对乙酰氨基酚与布洛芬混悬液治疗110例高热支气管炎患儿，对其疗效进行比较，现报道如下。     

布洛芬口服混悬液治疗上呼吸道感染的疗效观察

目的观察布洛芬口服混悬液治疗急性上呼吸道感染的临床疗效。方法选择急性上呼吸道感染并有高热症状的患儿128例,随机分成布洛芬组和对乙酰氨基酚组。其中布洛芬组有患儿64例,给予布洛芬口服混悬液治疗;对乙酰氨基酚组有患儿64例,给予对乙酰氨基酚口服混悬液治疗。记录患儿接受治疗后的体温变化情况以及不良反应,并对记录结果进行统计分析。结果布洛芬组(A组)和对乙酰氨基酚组(B组)均有效降低患儿的体温,较治疗前有明显的差异,差异有统计学意义(P0.05)。但布洛芬组能迅速降低患儿的体温,并维持在正常水平范围内;相对于布洛芬组,对乙酰氨基酚组降低患儿体温缓慢;两组间比较,布洛芬组的降温效果比对乙酰氨基酚组降温效果更好,差异有统计学意义(P0.05)。结论布洛芬口服混悬液治疗急性上呼吸道感染并高热患儿退热效果较好,不良反应少,值得临床使用。     

布洛芬混悬液在儿童发热中的应用与疗效

目的观察口服布洛芬混悬液的退热效果。方法将136例发热患儿分为口服2%布洛芬混悬液治疗组70例和肌注复方氨林巴比妥对照组66例,对两组患儿的体温变化及退热效果进行对比分析。结果两组患儿均在给药后30min内体温开始下降,治疗组体温下降明显优于对照组。治疗组用药4h后总有效67例,总有效率为95.7%;对照组总有效57例,总有效率为86.4%;两组比较,差异有统计学意义(P<0.05)。结论口服2%布洛芬混悬液退热起效快,退热效果良好,可作为儿科退热首选用药。     

布洛芬和对乙酰氨基酚治疗小儿感染性发热疗效比较

目的：了解布洛芬混悬液（美林）治疗儿童感染性发热的有效性和安全性,为临床选择1：1服退热药提供参考。方法：116例急性上呼吸道感染伴发热的患儿随机分为两组。治疗组72例,对照组44例,分别给予布洛芬（美林）和对乙酰氨基酚（泰诺林）治疗。结果：两组在服药后2h内退热的有效率分别为98．6％、95．5％,差异无统计学意义（P〉0．05）,但对照纽从服药自3～4h开始体温呈现回升趋势,而治疗组在服药后能雏持7～8h体温不回升,显效率分别为95．8％、70．5％,差异有统计学意义（P〈0．01）。结论：布洛芬混悬液退热作用强,维持时间久。     

Evaluation of ibuprofen versus aspirin and paracetamol on efficacy and comfort in children with fever

Objective: We compared efficacy and impact on the comfort of ibuprofen (7.5 mg/kg per dose), aspirin (10 mg/kg/dose) and paracetamol (10 mg/kg per dose) on children with fever aged 6–24 months in an open, randomised study with three parallel groups. Methods: The main criterion for efficacy was area under the curve (AUC) of percentage temperature reduction. Comfort was assessed on scores depending on general behaviour and degree of relief. General behaviour was assessed on a verbal scale and on a visual analogue scale (VAS) and the degree of relief was assessed in relation to baseline on a verbal scale. Results: The efficacy of ibuprofen was better than that of aspirin or paracetamol. In spite of more adverse events, the comfort scores were significantly in favour of ibuprofen 6 h after the first dose of treatment. Received: 29 March 1996 / Accepted in revised form: 2 August 1996     

布洛芬混悬液与复方氨基比林治疗小儿发热的疗效比较

目的:观察比较布洛芬混悬液与复方氨基比林的退热疗效.方法:选择有发热症状的患儿200例随机分成两组,分别用布洛芬混悬液和复方氨基比林治疗.结果:两组在第1 h内退热效果和退热速度相同,而布洛芬混悬液在第2 h就能使患儿体温降至接近正常体温,并能维持6～8 h;复方氨基比林未能将体温退至正常,用药3 h后体温有回升趋势.结论:与复方氨基比林比较,布洛芬混悬液退热效果好,维持时间长,不良反应轻微.     

布洛芬、赖氨匹林和对乙酰氨基酚治疗小儿发热的疗效比较

目的：比较布洛芬混悬液（美林）、注射用赖氨匹林、对乙酰氨基酚栓对急性呼吸道感染伴高热患儿的退热效果。方法：选择有急性呼吸道感染伴有发热症状的患儿170例,随机分为三组,分别给予布洛芬混悬液f美林）、赖氨匹林注射液、对乙酰氨基酚栓治疗。结果：在1h内,赖氨匹林注射液退热速度最快,布洛芬混悬液次之,对乙酰氨基酚栓最慢,三者两两间有非常显著性差异（S〉S0.01）。在1～2h,布洛芬混悬液退热速度最快,其次是对乙酰氨基酚栓,赖氨匹林注射液的退热速度最慢（P〈0．01）。在2～3h,布洛芬混悬液与赖氨匹林注射液的退热速度无显著性差异（P〉0．05）,两者快于对乙酰氨基酚栓（P〈0．01）,对乙酰氨基酚栓组的体温呈回升趋势。在3～8h,布洛芬混悬液仍有退热效果,与赖氨匹林注射液和对乙酰氨基酚栓有非常显著性差异（P〈0．01）,赖氨匹林注射液组和对乙酰氨基酚栓组的体温均呈现回升。布洛芬混悬液能在2h内使患儿体温降至正常,并能维持8h。赖氨匹林注射液能在2h内使患儿体温降至正常,并能维持3h,3-6h后体温呈回升趋势。对乙酰氨基酚栓给药后2～3h体温呈回升趋势。布洛芬混悬液、赖氨匹林注射液的总有效率均为100．0％,对乙酰氨基酚栓的总有效率为94．0％。布洛芬混悬液退热的显效率为90．0％．赖氨匹林注射液为92．0％,对乙酰氨基酚栓为36．0％：布洛芬混悬液和赖氨匹林注射液的疗效比较无显著性差异（P〉0．05）,两者优于对乙酰氨基酚栓（P〈0．01）。结论：布洛芬混悬液和赖氨匹林注射液的退热作用强,布洛芬混悬液的维持时间长,赖氨匹林注射液的维持时间中等,对乙酰氨基酚栓的退热作用较弱,维持时间短。     

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

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 placebo), controlled observational studies and large case series comprised more than 1000 participants.

Main outcome measures: Adverse events (AEs) requiring discontinuation of medication; systemic reactions related to ibuprofen or paracetamol; serious AEs that are fatal, life-threatening or require hospitalisation; and serious AEs not requiring hospitalisation.

Results: A total of 24 RCTs examined either ibuprofen and/or paracetamol versus placebo for AE data. Twelve other studies meeting our criteria were also included for AE data. Meta-analysis of systemic reactions demonstrated that tolerability and safety of ibuprofen was similar to placebo, as was paracetamol: ibuprofen versus placebo relative risk (RR) 1.39 (95% CI: 0.92, 2.10); paracetamol versus placebo RR 1.57 (95% CI 0.74, 3.33). A total of 2937 systemic AEs occurred in 21?305 patients taking ibuprofen compared with 1466 systemic AEs in 11?164 patients taking paracetamol: RR 1.03 (95% CI 0.98, 1.10). There was no significant difference between the two groups. Narrative analysis of AE data identified conflicting evidence regarding hepatic injury with paracetamol and group A streptococcal infections with ibuprofen or paracetamol treatment.

Conclusions: Ibuprofen, paracetamol and placebo have similar tolerability and safety profiles in terms of gastrointestinal symptoms, asthma and renal adverse effects. While the study data investigated here may not reflect over-the-counter use, these results are still relevant in the context of any safety concerns relating to general ibuprofen or paracetamol treatment in children.     

Safety profile of ibuprofen suspension in young children

The Children’s Analgesic Medicine Project (CAMP) was a multicenter, all-comers, openlabel, prospective study to compare the safety of ibuprofen suspension with acetaminophen suspension in children with fever and/or pain. Four hundred and twenty four (424) pediatricians enrolled 41 810 children (aged 1 month to 18 years old) at 69 US clinics. Safety data included information concerning medication use and adverse events (AEs) summarized by severity and analyzed by age groups (younger and older than 2 years). Among 30 144 children who took at least one dose of ibuprofen or acetaminophen, 14 281 were younger (< 2 yrs) and 15 863 were older (⩾ 2 to < 12 yrs). Within both age groups, the incidence rates for specific AEs, including abdominal pain, insomnia, and hyperkinesia were rare and generally < 1% for both treatments. For younger children, fever, vomiting, diarrhea, rhinitis, rash and otitis media were the only AEs with an incidence rate > 1% (in either treatment group). For older children, the only AEs with an incidence rate > 1% in either group were rhinitis, pharyngitis and otitis media. AEs were generally mild to moderate for both treatments within the two age groups. There were no serious AEs, including anaphylaxis, Reye’s syndrome, renal failure, GI bleeding/perforation or necrotizing fasciitis. There was a slightly higher overall incidence of side effects in the ibuprofen group (17.6% vs. 15.0%) for the younger children; and similar results were seen in the older children (11.9% vs. 10.7%). This may have been due to the preference of physicians to treat the sicker children with ibuprofen. There were four deaths, all unrelated to study medication, all occurring in children < 2 yrs (herpes encephalitis, sepsis due to 5. pneumoniae, medulloblastoma, and sudden infant death syndrome). The safety of ibuprofen suspension in children < 2 yrs was demonstrated in this study. The safety profile in children < 2 yrs is consistent with the excellent profile observed in children ⩾ 2 yrs. Overall, ibuprofen exhibited an AE profile similar to acetaminophen in both younger and older children.     

Ibuprofen versus paracetamol in pediatric fever: objective and subjective findings from a randomized,blinded study

ABSTRACT

Objective: The main objective of this study was to compare the single-dose efficacy of 15?mg/kg paracetamol (acetaminophen) versus 10?mg/kg ibuprofen in a general practice setting.

Methods: Children from the age of 3 months to 12 years with a fever of non-serious origin were randomized to receive either ibuprofen or paracetamol. The first dose was given double-blind, using a double-dummy technique. Tympanic temperature was measured at baseline and over the following 8 hours. The second and subsequent doses were administered open-label for up to 3 days by parents at home. At the end of the double-blind and the open-label periods, parents were asked to subjectively rate the efficacy of the product and state whether they would treat their child with the product again. The primary endpoint of the study was the area under the temperature reduction curve expressed as an absolute difference from baseline, from 0 to 6 hours (AUC_0–6).Secondary efficacy endpoints included a variety of objective and subjective measures.

Results: No statistically significant differences in the primary endpoint or any of the objective secondary endpoints were observed. Both agents were equally well tolerated. Compared with parents in the paracetamol group, significantly more parents in the ibuprofen group rated the drug as very efficacious, and reported that they would use the drug again in both the double-blind and open-label phases of the study.

Conclusions: Ibuprofen at a dose of 10?mg/kg and paracetamol at a dose of 15?mg/kg have equivalent efficacy and tolerability; parental opinion in favor of ibuprofen could be explained by additional benefits of ibuprofen that were not measured in this trial and helped allay their anxiety over the treatment of their child.     

Pharmacokinetics of ibuprofen in febrile children

Summary Ibuprofen may be an alternative to acetaminophen to control fever in children but little is known about its pharmacokinetics in pediatric patients. We studied 17 patients (age 3–10 yr) with fever; the most prevalent diagnoses were streptococcal pharyngitis and otitis media. Ibuprofen liquid was given as a single dose, 5 mg/kg (9 patients) or 10 mg/kg (8 patients). Multiple blood samples were collected over 8 hours and analyzed by HPLC.The maximum observed serum concentrations of ibuprofen ranged from 17–42 m·ml^–1 at 5 mg·kg^–1 and 25–53 m·ml^–1 at 10 mg·kg^–1 doses. Pharmacokinetics did not appear to be affected by ibuprofen dose. Mean t_max, oral clearance and elimination half life were 1.1 h, 1.2 ml·min^–1·kg^–1, and 1.6 h, respectively in patients at 5 mg·kg^–1 doses; the corresponding values were 1.2 h, 1.4 ml·min^–1·kg^–1, and 1.6 h in those receiving 10 mg·kg^–1 doses. There was no relationship between age and ibuprofen kinetics. No adverse effects occurred in any patients.These data suggest that ibuprofen pharmacokinetics may not be affected by dose between 5 and 10 mg/kg or age between 3 and 10 years.     

Comparative efficacy and tolerance of ibuprofen syrup and acetaminophen syrup in children with pyrexia associated with infectious diseases and treated with antibiotics

A double-blind, randomised, parallel group study has been done comparing the efficacy and tolerability of 7.5 mg/kg ibuprofen syrup (n=77) and 10 mg·kg^–1 acetaminophen syrup (n=77) in 154 children (6 months to 5 years) with fever (38°C) associated with infectious diseases and treated with antibiotic therapy.The area under the percentage reduction in temperature curve captured the net effect of each drug and provided the best estimate for comparison of efficacy during a defined period. Temperature evolution over time was not significantly different between the two groups. Nevertheless, the temperature reduction over the first 4 h of treatment (H0–H4) was significantly higher after ibuprofen (60%) than acetaminophen (45%). Both ibuprofen and acetaminophen were well tolerated.In conclusion, significant antipyretic activity, good tolerability and its availability as a syrup make ibuprofen an effective means of fever control in children.