Published 13 October 2008, doi:10.1136/bmj.a2072
Cite this as: BMJ 2008;337:a2072

Letters

Paracetamol with ibuprofen

Ibuprofen is a marker of soft tissue infection

The first 150 words of the full text of this article appear below.

The references cited in Ospina and Salcedo’s letter seem not to support the authors’ affirmation that ibuprofen increases the risk of soft tissue infection in varicella.1 Reference 3—the only methodologically sound study—says that the study data do not support the hypothesis that non-steroidal anti-inflammatory drugs, or ibuprofen in particular, increase the risk of necrotising group A streptococcal infections.

Reference 4 concludes that the risk of invasive group A streptococcal infection was associated with demographic and environmental factors and persistent high fever. There was no association with the use of ibuprofen or paracetamol alone, but the use of both agents was significantly associated with streptococcal infection. These studies show that children with fever tolerate treatment with ibuprofen as well as treatment with paracetamol. Neither agent is associated with an increased risk of necrotising soft tissue infections.

The conclusion is that persistent high fever in patients receiving ibuprofen or paracetamol after varicella . . . [Full text of this article]

Nicholas D Moore, director, clinical research and clinical pharmacology1

1 Bordeaux University Hospital, F-33076 Bordeaux, France

nicholas.moore@pharmaco.u-bordeaux2.fr


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