Alert on the risks associated with the use of ibuprofen: it amplifies the effects of bacteria such as streptococcus and worsens infections

The French drug agency (ANSM) claims to have verified that the ibuprofen and the ketoprofen can aggravate the same infections intended to treat these drugs and asked for an investigation at European level. He also issued a series of recommendations for professionals and patients (see the list at the bottom of this note).

A spokesman for the French National Agency for the Safety of Medicines and Medical Devices (ANSM) told the news agency EFE What?at the request of France"a collegial badysis will be conducted with its European counterparts.

The spokesman recalled that the authorization of drugs they are made for all of Europe, not only for France, and it is at this scale that we have to make a rebadessment of the benefit / risk ratio of these products.

The ANSM, which launched a pharmacological survey last June through its centers in Tours and Marseille, published a series of recommendations on Thursday: first, the privilege of paracetamol on ibuprofen and ketoprofen in case of pain or fever,especially when it comes to infections such as angina, nasopharyngitis, otitis, cough, lungs and even in case of skin lesion or chicken pox.

They also gave rules of good use of these two anti-inflammatories, start using "the minimum effective dose, for the shortest duration", stop treatment as soon as the symptoms disappear, do not prolong it for more than three days in case of fever, or more than five days in case of pain.

These recommendations stem from a study commissioned in June 2018 by its regional centers in Tours and Marseille, which concluded that there are a number of infections, especially streptococcus, which could be aggravated by taking these two drugs.

These complications were observed after very short treatment periods (two to three days) when ibuprofen or ketoprofen has been prescribed (or used for self-medication) for fever, mild skin problems with inflammatory, respiratory or otolaryngological symptoms.

In the cases studied, which date back to an extended period started in 2000, French researchers badyzed 337 infectious complications with ibuprofen and 49 with ketoprofen who had a severe character and were at the origin of hospitalizations, sequelae and even deaths.

Ibuprofen is the second most used badgesic (badgesic) in France for the first level of severity, after paracetamol.

Results of the report of the French drug agency

[Resumen publicado en su página oficial] After reports of serious infectious complications with nonsteroidal anti-inflammatory drugs (NSAIDs), used to fight fever or pain, the ANSM (French Drug Agency) commissioned a national survey to evaluate the reactions to the use of the two most used drugs: ibuprofen. and ketoprofen.

The results of this survey suggest the aggravating role of ibuprofen and ketoprofen in case of infection. ANSM shared these results with its European counterparts to launch a joint badysis.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and ketoprofen, are the subject of pharmacovigilance reports on serious infectious complications.

The regional centers of Tours and Marseille conducted a study to study the risk of serious infectious complications badociated with the use of NSAIDs in adults and children.

The purpose of this investigation was to determine if these serious infectious complications were promoted by NSAIDs or if they reflected the evolution of the initial infectious pathology.

The results of the investigation

Of all the cases reported since 2000, 337 were selected for infectious complications with ibuprofen and 49 cases with ketoprofen after taking into account only the most serious cases in children or adults (often young) without risk factors.

These are Serious infections of the skin and soft tissues, Infections pleuropulmonary and infections neurologicalamong other things, resulting in hospitalizations, after-effects or even death.

These infectious complications (mainly streptococci or pneumococci) were observed after a very short period of treatment (2 to 3 days), even when NSAIDs have been badociated with antibiotic therapy. Occurred when ibuprofen or ketoprofen was prescribed or self-medicated for feverbut also in many other circumstances, as benign inflammatory lesions of the skin (local reaction or insect sting), respiratory manifestations (cough or lung infection) or in case of angina or otitis.

The badysis of these cases, as well as the badysis of data from experimental and pharmacoepidemiological studies, suggest that these infections, particularly streptococci, can be aggravated by taking these NSAIDs.

The survey also shows that the use of these NSAIDs is persistent in the case of chickenpox. The French drug agency recalls that NSAIDs They are already known to cause serious bacterial complications of the skin when they are used during chickenpox and should be avoided in this case.

In this context, the agency warns healthcare professionals, patients and parents about the risk of serious infectious complications that can have serious consequences on the health of patients.

Martial Fraysse, president of the Order of Pharmacies of Ile de France (Paris region) and member of the Academy of Pharmacy, is adamant. Accessed by Radio France about why did you wait so long to throw this warning, says that in fact "more than 20 years ago" that his sector "discourages the use of certain anti-inflammatory drugs such as ibuprofen or ketoprofen in children and young adults after experiencing serious adverse events in the population. "For about twenty years, we have detected two deaths a year, in addition to serious infectious complications," he says. two bacteria, pneumococci or streptococci, which have brutally amplified their effects through the use of these anti-inflammatories. They should not be used in this way, even in the short term, because of the danger they represent. "

The rules for the correct use of NSAIDs in case of pain and / or fever are:

-Prescribe and use NSAIDs at the lowest effective dose for the shortest duration.

– Stop treatment as soon as symptoms disappear.

-Avoid NSAIDs in case of chicken pox.

-Do not prolong treatment beyond three days in case of fever.

-Do not extend beyond five days in case of pain.

-Do not take two nonsteroidal anti-inflammatory drugs at the same time.