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FPIN's Clinical Inquiries. Aspirin use in children for fever or viral syndromes

Anthony I Beutler1, Gregory T Chesnut, John C Mattingly

  • 1Uniformed Services University of the Health Sciences, Bethesda, MD, USA. abeutler@usuhs.mil

American Family Physician
|December 17, 2009
PubMed

Insights

Aspirin is not recommended for treating viral illnesses in children due to its association with Reye syndrome. Safer alternatives exist for fever reduction in pediatric patients.

Area of Science:

  • Pediatric Medicine
  • Pharmacology
  • Epidemiology

Background:

  • Aspirin (acetylsalicylic acid) is commonly used for pain and fever.
  • Reye syndrome is a rare but serious condition affecting the brain and liver.
  • Previous studies suggest a link between aspirin use and Reye syndrome in children.

Purpose of the Study:

  • To evaluate the safety and efficacy of aspirin in treating acute febrile viral illnesses in children.
  • To assess the association between aspirin use and the development of Reye syndrome.
  • To provide recommendations on aspirin use in pediatric populations.

Main Methods:

  • Review of case-control and historic cohort studies.
  • Analysis of existing epidemiological data on Reye syndrome.
  • Expert opinion synthesis.

Main Results:

  • Aspirin use is associated with Reye syndrome in children, though a causal link is not definitively proven.
  • The risk of Reye syndrome decreases with age, being very rare in late adolescence.
  • Other nonsteroidal anti-inflammatory drugs (NSAIDs) are effective antipyretics and lack this association.

Conclusions:

  • Aspirin should be avoided for acute febrile viral illnesses in children.
  • Pediatric aspirin use should be restricted to specific conditions like Kawasaki disease and juvenile arthritis.
  • Alternative antipyretics are recommended for febrile viral illnesses in children under 19.

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