非甾体抗炎药(NSAIDs)通常用于婴儿,孩子们,和世界各地的青少年;然而,尽管有足够的证据表明NSAIDs对儿童和青少年的有益作用,婴儿缺乏全面的数据。本综述总结了现有数据可用于婴儿的各种非甾体抗炎药的安全性和有效性的最新知识。包括布洛芬,去布洛芬,酮洛芬,氟比洛芬,萘普生,双氯芬酸,酮咯酸,吲哚美辛,尼氟丁酸,美洛昔康,塞来昔布,帕瑞昔布,罗非考昔,乙酰水杨酸,还有尼美舒利.NSAIDs的疗效已被证明适用于各种疾病,如发烧和疼痛。NSAIDs也是抗炎治疗的主要支柱,如小儿炎症性风湿性疾病。关于大多数NSAIDs在婴儿中的安全性的数据有限。药物不良反应可能是肾脏,胃肠,血液学,或免疫学。由于NSAIDs是儿科人群中最常用的药物之一,安全性和有效性研究可以作为正常临床常规的一部分进行,甚至在年轻的婴儿。可用数据源,例如(电子)医疗记录,应用于安全性和有效性分析。在更大的范围内,现有数据源,例如,药物不良反应计划/网络,自发的国家报告系统,和电子医疗记录应使用儿童特定方法进行评估,以检测与某些儿科年龄组或疾病实体相关的安全信号。为了提高NSAIDs在婴儿中的安全性,治疗需要以适合年龄或基于体重的最低剂量开始。应定期评估治疗持续时间和药物使用量,并应遵循制造商或专家委员会的最大剂量限制和其他建议。非慢性疾病如发热和急性(术后)疼痛的治疗应尽可能短。慢性疾病患者应定期监测NSAIDs可能的不良反应。
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used in infants, children, and adolescents worldwide; however, despite sufficient evidence of the beneficial effects of NSAIDs in children and adolescents, there is a lack of comprehensive data in infants. The present
review summarizes the current knowledge on the safety and efficacy of various NSAIDs used in infants for which data are available, and includes ibuprofen, dexibuprofen, ketoprofen,
flurbiprofen, naproxen, diclofenac, ketorolac, indomethacin, niflumic acid, meloxicam, celecoxib, parecoxib, rofecoxib, acetylsalicylic acid, and nimesulide. The efficacy of NSAIDs has been documented for a variety of conditions, such as fever and pain. NSAIDs are also the main pillars of anti-inflammatory treatment, such as in pediatric inflammatory rheumatic diseases. Limited data are available on the safety of most NSAIDs in infants. Adverse drug reactions may be renal, gastrointestinal, hematological, or immunologic. Since NSAIDs are among the most frequently used drugs in the pediatric population, safety and efficacy studies can be performed as part of normal clinical routine, even in young infants. Available data sources, such as (electronic) medical records, should be used for safety and efficacy analyses. On a larger scale, existing data sources, e.g. adverse drug reaction programs/networks, spontaneous national reporting systems, and electronic medical records should be assessed with child-specific methods in order to detect safety signals pertinent to certain pediatric age groups or disease entities. To improve the safety of NSAIDs in infants, treatment needs to be initiated with the lowest age-appropriate or weight-based dose. Duration of treatment and amount of drug used should be regularly evaluated and maximum dose limits and other recommendations by the manufacturer or expert committees should be followed. Treatment for non-chronic conditions such as fever and acute (postoperative) pain should be kept as short as possible. Patients with chronic conditions should be regularly monitored for possible adverse effects of NSAIDs.