Journal Club: Acetaminophen for Fever in Children With Asthma

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Acetaminophen may be the antipyretic choice for many families, but a new study asks whether it could be a problem for children with asthma.

Children with asthma who use a nonsteroidal anti-inflammatory drug (NSAID) during a respiratory infection or no antipyretic at all have a lower risk of experiencing an asthma exacerbation (AE) than asthmatics who use acetaminophen. These were the findings of an analysis of data from a national database in Taiwan related to more than 27,000 children with asthma who had at least one episode of respiratory infection and a similar number of age- and sex-matched non-asthmatic children with respiratory infection who served as controls.

 Participants were divided into 3 groups: acetaminophen use, NSAID cyclooxygenase-1 (COX-1) use, and no antipyretic use. Overall, asthmatic patients used antipyretics less often than controls (48.5% vs 55.5%) with antipyretic users in the asthmatic group tending to be older than nonusers (9.3 vs 7.8 years).

 Investigators compared the rate of AE occurrence within the first 7 days after diagnosis of respiratory infection among the groups and analyzed the risk of AE with adjustments for age, gender, and urbanization level. The overall rate of AE within 7 days of a single respiratory infection episode was low-- about 0.14%, with no observable difference in rate between those who used antipyretics and those who did not. However, the risk of AE was highest in those who took acetaminophen (Chung R-S, et al. Science Direct. 2020; Epub ahead of print).

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