Severe necrotizing soft-tissue infections and nonsteroidal anti-inflammatory drugs

Abstract

Despite the limitations related to a spontaneous reporting system, this study indicates a strong association between NSAID use and NSTI. Although it was not possible to conclude if NSAIDs increase the risk of necrotizing complications in all patients, their use may mask the symptoms and delay diagnosis.

Benefits and strengths of the disproportionality analysis for identification of adverse drug reactions in a pharmacovigilance database

“…The case-noncase analysis performed in the French PharmacoVigilance database [7] led to the same conclusions as a case-control study,a method more expensive,longer and more difficult to perform. Thus, this method could be proposed,in a context of signal detection,for testing a working hypothesis before performing larger pharmacoepidemiological studies (case-control or cohort studies).…”

“…All disproportionality analysis in a pharmacovigilance database requires a clear pharmacodynamic hypothesis established on basic properties of drugs. Several examples are given in the present paper, such as the carcinogenic properties of pioglitazone on bladder [5], the thrombotic risk of coxibs [6] and the involvement of nonsteroidal anti-inflammatory drugs in necrotizing soft-tissue infections [7]. This case-noncase method cannot be used for investigating all risks of all drugs without a strong basic pharmacodynamic hypothesis.…”

Management of acute fever in children: Guideline for community healthcare providers and pharmacists

“…(Evidence A) • The use of NSAIDs has been associated with an elevated risk of severe skin and soft-tissue infections in patients with varicella zoster virus infection. [19][20][21] Therefore, paracetamol is recommended as the antipyretic of choice in children with chicken pox.…”

Varicella zoster virus infection

“…Accordingly, and even though early antiviral therapy can reduce the duration of illness 165 , treatment of uncomplicated varicella in children is usually confined to symptomatic relief. Acetaminophen (paracetamol) is the preferred antipyretic agent because of the association between aspirin and Reye syndrome (life-threatening sudden onset encephalopathy and liver dysfunction) 166 and because of an epidemiological link between ibuprofen and an increased risk of invasive group A streptococcal disease in the context of varicella, although not necessarily a causal one 167 . Topical anti-pruritic agents are of anecdotal benefit.…”