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Ibuprofen as risk-factor for complications of acute anterior sinusitis in children - 16/10/19

Doi : 10.1016/j.anorl.2019.10.004 
R. Nicollas a, , E. Moreddu a, C. Le Treut-Gay a, J. Mancini c, M. Akkari d, M. Mondain d, D. Scavarda b, G. Hosanna e, P. Fayoux e, S. Pondaven-Letourmy f, E. Lescanne f, J.-M. Triglia a
a Aix-Marseille University, Department of Pediatric Otolaryngology Head and Neck Surgery, La Timone Children's Hospital, 264, rue St Pierre, 13385 Marseille cedex 5, France 
b Aix-Marseille University, Department of Pediatric Neurosurgery, La Timone Children's Hospital, 264, rue St Pierre, 13385 Marseille cedex 5, France 
c Aix-Marseille University Department of Biostatistics and Communication and Information Technologies, BiosTIC, La Timone Hospital, Inserm, IRD, UMR912 SESSTIMF, 264, rue Saint Pierre, 13385 Marseille cedex 5, France 
d Department of Otolaryngology Head and Neck Surgery, Gui de Chauliac Hospital, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France 
e Department of Otolaryngology Head and Neck Surgery, avenue Eugène-Avinée, 59037 Lille, France 
f Department of Otolaryngology Head and Neck Surgery, Gatien Clocheville Children's Hospital, 49, boulevard Béranger, 37000 Tours, France 

Corresponding author at: Department of Pediatric Otolaryngology Head and Neck Surgery, La Timone Children's Hospital, 264, rue St Pierre, 13385 Marseille cedex 5, France.Department of Pediatric Otolaryngology Head and Neck Surgery, La Timone Children's Hospital264, rue St PierreMarseille cedex 513385France
En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 16 October 2019
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Abstract

Importance

Non-steroidal anti-inflammatory drugs (NSAIDs) are known to inhibit chemotaxis, oxidative burst and phagocytosis, bacterial killing in granulocytes as well as inhibiting neutrophil aggregation or degranulation, thereby interfering with the function of lymphocytes. On the other hand, ibuprofen is widely prescribed in pediatrics for its powerful analgesic and antipyretic effects. To our knowledge, no previous publication outlines the relationship between Ibuprofen therapy and an increased risk of intracranial and/or orbital complications of acute fronto-ethmoidal sinusitis in childhood.

Objective

To look for a relationship between ibuprofen and occurrence of intra-cranial and/or orbital complications of acute fronto-ethmoidal sinusitis in pediatrics.

Setting and methods

The medical charts of patients younger than 18 years admitted into the E.N.T. departments of 4 academic care centers during 2 consecutive years for fronto ethmoidal sinusitis were reviewed retrospectively. The history of ibuprofen intake, the occurrence of complication (orbital or intracranial) as well as the usual demographic data were noted. A statistical analysis was performed in order to ascertain whether a relationship between taking NSAIDs and the onset of an intracranial and/or orbital complication exists.

Results

Intake of ibuprofen appeared to be a risk-factor of intracranial complications or associated orbital and intracranial complications of acute fronto-ethmoidal sinusitis in children. Neither gender nor age nor initial pain intensity were statistically related to the onset of complications.

Conclusion and relevance

This retrospective multicenter cohort study appears to suggest that ibuprofen increases the risk of orbital and/or intracranial complications of acute fronto-ethmoidal sinusitis in childhood. Therefore, we recommend not prescribing ibuprofen if one suspects an acute sinusitis in a child or adolescent.

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Keywords : Ibuprofen, NSAID, Acute sinusitis, Complication, Empyema


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