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Impact of antipyretics on acute asthma exacerbation during respiratory infection-A nationwide population-based study

Ruei-Sian Chung1, Yung-Chieh Huang2, Yi-Huei Chen3

  • 1Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Pediatrics, Chang-Hua Hospital, Ministry of Health and Welfare, Taiwan.

Pediatrics and Neonatology
|April 26, 2020
PubMed

Insights

Acetaminophen use in children with asthma and respiratory infections may increase the risk of severe asthma exacerbation (AE). Avoiding acetaminophen and using other antipyretics like NSAID cyclooxygenase-1 (COX-1) showed a lower risk of AE.

Area of Science:

  • Pediatric Pulmonology
  • Clinical Pharmacology
  • Epidemiology

Background:

  • Antipyretics are commonly used in children.
  • Both acetaminophen and NSAIDs may increase asthma exacerbation risk.
  • Limited data exists on antipyretic risks in pediatric asthmatics during respiratory infections.

Purpose of the Study:

  • To investigate antipyretic use in children with respiratory infections.
  • To analyze the risk of acetaminophen and NSAID (COX-1) for severe asthma exacerbation (AE) in pediatric asthmatics.

Main Methods:

  • Utilized Taiwan's National Health Insurance Research Database (2005).
  • Included 27,095 pediatric asthmatic patients and 27,095 matched non-asthmatic controls with respiratory infections.
  • Compared AE occurrence within 7 days post-infection diagnosis among acetaminophen, NSAID (COX-1), and no antipyretic groups.

Main Results:

  • Asthmatic patients used fewer antipyretics than controls during respiratory infections (48.51% vs. 55.50%).
  • No significant difference in AE risk was found between overall antipyretic users and non-users (0.167% vs. 0.086%).
  • Compared to no antipyretic use, acetaminophen use showed a higher risk of AE (OR: 0.26), while NSAID (COX-1) use showed a lower risk (OR: 0.14).

Conclusions:

  • The overall rate of AE in asthmatic children post-respiratory infection was 0.144%.
  • Acetaminophen use was associated with an increased risk of asthma exacerbation.
  • Avoiding acetaminophen and opting for NSAID (COX-1) may reduce AE risk in pediatric asthmatics during respiratory infections.
Abstract

Keywords:
NSAID COX-1acetaminophenasthma exacerbation (AE)

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