Nonsteroidal Anti-Inflammatory Drugs: A survey of practices and concerns of pediatric medical and surgical specialists and a summary of available safety dataReport as inadecuate




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Pediatric Rheumatology

, 8:7

First Online: 04 February 2010Received: 02 October 2009Accepted: 04 February 2010

Abstract

ObjectivesTo examine the prescribing habits of NSAIDs among pediatric medical and surgical practitioners, and to examine concerns and barriers to their use.

MethodsA sample of 1289 pediatricians, pediatric rheumatologists, sports medicine physicians, pediatric surgeons and pediatric orthopedic surgeons in the United States and Canada were sent an email link to a 22-question web-based survey.

Results338 surveys 28% were completed, 84 were undeliverable. Of all respondents, 164 50% had never prescribed a selective cyclooxygenase-2 COX-2 NSAID. The most common reasons for ever prescribing an NSAID were musculoskeletal pain, soft-tissue injury, fever, arthritis, fracture, and headache. Compared to traditional NSAIDs, selective COX-2 NSAIDs were believed to be as safe 42% or safer 24%; have equal 52% to greater efficacy 20% for pain; have equal 59% to greater efficacy 15% for inflammation; and have equal 39% to improved 44% tolerability. Pediatric rheumatologists reported significantly more frequent abdominal pain 81% vs. 23%, epistaxis 13% vs. 2%, easy bruising 64% vs. 8%, headaches 21% vs. 1% and fatigue 12% vs. 1% for traditional NSAIDs than for selective COX-2 NSAIDs. Prescribing habits of NSAIDs have changed since the voluntary withdrawal of rofecoxib and valdecoxib; 3% of pediatric rheumatologists reported giving fewer traditional NSAID prescriptions, and while 57% reported giving fewer selective COX-2 NSAIDs, 26% reported that they no longer prescribed these medications.

ConclusionsTraditional and selective COX-2 NSAIDs were perceived as safe by pediatric specialists. The data were compared to the published pediatric safety literature.

List of AbbreviationsAAPAmerican Academy of Pediatrics

ACRAmerican College of Rheumatology

CARRAChildren-s Arthritis and Rheumatology Research Alliance

COXcyclooxygenase

FDAFood and Drug Administration

MSKmusculoskeletal

NSAIDnonsteroidal anti-inflammatory drug

PDApatent ductus arteriosus.

Electronic supplementary materialThe online version of this article doi:10.1186-1546-0096-8-7 contains supplementary material, which is available to authorized users.

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Author: Deborah M Levy - Lisa F Imundo

Source: https://link.springer.com/







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