Impact of antipyretics on acute asthma exacerbation during respiratory infection—A nationwide population-based study
Background: Antipyretics are frequently used in pediatric practice. Both acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to increase the risk of asthma exacerbation. The study investigated antipyretic use during respiratory infection in children and analyzed the ri...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-10-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957220300589 |
| _version_ | 1818792027181023232 |
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| author | Ruei-Sian Chung Yung-Chieh Huang Yi-Huei Chen Lin-Shien Fu Ching-Heng Lin |
| author_facet | Ruei-Sian Chung Yung-Chieh Huang Yi-Huei Chen Lin-Shien Fu Ching-Heng Lin |
| author_sort | Ruei-Sian Chung |
| collection | DOAJ |
| description | Background: Antipyretics are frequently used in pediatric practice. Both acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to increase the risk of asthma exacerbation. The study investigated antipyretic use during respiratory infection in children and analyzed the risk of acetaminophen and NSAID for severe asthma exacerbation (AE) in asthmatic children in Taiwan. Methods: We used the data from the National Health Insurance Research Database in 2005. There were 27,095 pediatric asthmatic patients having at least one respiratory infection episode, and 27,095 age- and sex-matched non-asthmatic children with respiratory infection served as controls. These patients were divided into groups with acetaminophen use, NSAID cyclooxygenase-1 (COX-1) use, and no antipyretic use. The rate of AE occurrence within the first 7 days after respiratory infection diagnosis was compared among the groups. Results: During a single episode of respiratory infection, asthmatic patients used fewer antipyretics than controls (48.51% vs. 55.50%, p < 0.001). No difference was observed in the risk of AE occurrence within 7 days after respiratory infection between antipyretic users and antipyretic nonusers (22/13,144 [0.167%] vs. 12/13,951 [0.086%], p = 0.058). Compared with asthmatic children using acetaminophen, those using no antipyretic and COX-1 have lower risks for AE (OR: 0.26, 95% CI: 0.12–0.54, p < 0.001; and OR: 0.14, 95% CI: 0.03–0.61, p = 0.009). Conclusion: In asthmatic children, the rate of AE after a single respiratory infection episode was around 0.144%. The risk of AE was higher in those who took acetaminophen. |
| first_indexed | 2024-12-18T15:20:43Z |
| format | Article |
| id | doaj.art-8bae0a99ae6a43d09e2d7bf3fb81baf9 |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-12-18T15:20:43Z |
| publishDate | 2020-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-8bae0a99ae6a43d09e2d7bf3fb81baf92022-12-21T21:03:25ZengElsevierPediatrics and Neonatology1875-95722020-10-01615475480Impact of antipyretics on acute asthma exacerbation during respiratory infection—A nationwide population-based studyRuei-Sian Chung0Yung-Chieh Huang1Yi-Huei Chen2Lin-Shien Fu3Ching-Heng Lin4Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Pediatrics, Chang-Hua Hospital, Ministry of Health and Welfare, TaiwanDepartment of Pediatrics, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Medical Research, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Pediatrics, National Yang-Ming University, Taipei, Taiwan; Corresponding author. Division of Immunology and Nephrology, Departments of Pediatrics, Taichung Veterans General Hospital, Number 160, Chung-Kang Road, Section 3, Taichung City 40705, Taiwan.Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan; Corresponding author. Departments of Medical Research, Taichung Veterans General Hospital, Number 160, Chung-Kang Road, Section 3, Taichung City 40705, Taiwan.Background: Antipyretics are frequently used in pediatric practice. Both acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) have been reported to increase the risk of asthma exacerbation. The study investigated antipyretic use during respiratory infection in children and analyzed the risk of acetaminophen and NSAID for severe asthma exacerbation (AE) in asthmatic children in Taiwan. Methods: We used the data from the National Health Insurance Research Database in 2005. There were 27,095 pediatric asthmatic patients having at least one respiratory infection episode, and 27,095 age- and sex-matched non-asthmatic children with respiratory infection served as controls. These patients were divided into groups with acetaminophen use, NSAID cyclooxygenase-1 (COX-1) use, and no antipyretic use. The rate of AE occurrence within the first 7 days after respiratory infection diagnosis was compared among the groups. Results: During a single episode of respiratory infection, asthmatic patients used fewer antipyretics than controls (48.51% vs. 55.50%, p < 0.001). No difference was observed in the risk of AE occurrence within 7 days after respiratory infection between antipyretic users and antipyretic nonusers (22/13,144 [0.167%] vs. 12/13,951 [0.086%], p = 0.058). Compared with asthmatic children using acetaminophen, those using no antipyretic and COX-1 have lower risks for AE (OR: 0.26, 95% CI: 0.12–0.54, p < 0.001; and OR: 0.14, 95% CI: 0.03–0.61, p = 0.009). Conclusion: In asthmatic children, the rate of AE after a single respiratory infection episode was around 0.144%. The risk of AE was higher in those who took acetaminophen.http://www.sciencedirect.com/science/article/pii/S1875957220300589asthma exacerbation (AE)acetaminophenNSAID COX-1 |
| spellingShingle | Ruei-Sian Chung Yung-Chieh Huang Yi-Huei Chen Lin-Shien Fu Ching-Heng Lin Impact of antipyretics on acute asthma exacerbation during respiratory infection—A nationwide population-based study Pediatrics and Neonatology asthma exacerbation (AE) acetaminophen NSAID COX-1 |
| title | Impact of antipyretics on acute asthma exacerbation during respiratory infection—A nationwide population-based study |
| title_full | Impact of antipyretics on acute asthma exacerbation during respiratory infection—A nationwide population-based study |
| title_fullStr | Impact of antipyretics on acute asthma exacerbation during respiratory infection—A nationwide population-based study |
| title_full_unstemmed | Impact of antipyretics on acute asthma exacerbation during respiratory infection—A nationwide population-based study |
| title_short | Impact of antipyretics on acute asthma exacerbation during respiratory infection—A nationwide population-based study |
| title_sort | impact of antipyretics on acute asthma exacerbation during respiratory infection a nationwide population based study |
| topic | asthma exacerbation (AE) acetaminophen NSAID COX-1 |
| url | http://www.sciencedirect.com/science/article/pii/S1875957220300589 |
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