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Truffert E, Fournier Charrière E, Treluyer JM, Blanchet C, Cohen R, Gardini B, Haas H, Liard F, Montastruc JL, Nicollas R, Pondaven S, Stahl JP, Wood C, Couloigner V. Guidelines of the French Society of Otorhinolaryngology (SFORL): Nonsteroidal anti-inflammatory drugs (NSAIDs) and pediatric ENT infections. Short version. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:289-294. [PMID: 31420238 DOI: 10.1016/j.anorl.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To present the guidelines of the French Society of Otolaryngology-Head and Neck Surgery concerning the use of non-steroidal anti-inflammatory drugs (NSAIDs) in pediatric ENT infections. METHODS Based on a critical analysis of the medical literature up to November 2016, a multidisciplinary workgroup of 11 practitioners wrote clinical practice guidelines. Levels of evidence were classified according to the GRADE (Grades of Recommendation, Assessment, Development and Evaluation) system: GRADE A, B, C or "expert opinion". The first version of the text was reworked by the workgroup following comments by the 22 members of the reading group. RESULTS The main recommendations are: NSAIDs are indicated at analgesic doses (e.g. 20-30 mg/kg/day for ibuprofen) in combination with paracetamol (acetaminophen) in uncomplicated pediatric ENT infections (acute otitis media, tonsillitis, upper respiratory infections, and maxillary sinusitis) if: o pain is of medium intensity (visual analogue scale (VAS) score 3-5 or "Evaluation Enfant Douleur" (EVENDOL) child pain score 4-7) and insufficiently relieved by first-line paracetamol (residual VAS≥3 or EVENDOL≥4); o pain is moderate to intense (VAS 5-7 or EVENDOL 7-10). When combined, paracetamol and ibuprofen are ideally taken simultaneously every 6h. It is recommended: (1) o not to prescribe NSAIDs in severe or complicated pediatric ENT infections; (2) o to suspend NSAIDs treatment in case of unusual clinical presentation of the infection (duration or symptoms); (3) o not to prescribe NSAIDs for more than 72h.
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Affiliation(s)
- E Truffert
- Service d'ORL, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France
| | - E Fournier Charrière
- CETD, service de pédiatrie, groupe Pédiadol, CHU Bicêtre, AP-HP, 94270 Le Kremlin-Bicêtre, France
| | - J-M Treluyer
- Centre d'investigation clinique, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France
| | - C Blanchet
- Service d'ORL, hôpital-Gui de-Chauliac, CHU de Montpellier, 34295 Montpellier, France
| | - R Cohen
- Service de pédiatre, centre hospitalier intercommunal de Créteil, 94000 Créteil, France
| | - B Gardini
- Clinique Sarrus-Teinturiers, 31300 Toulouse, France
| | - H Haas
- Service des urgences, hôpital CHU Lenval, 06200 Nice, France
| | | | - J-L Montastruc
- Service de pharmacologie clinique, hôpital La Grave, CHU de Toulouse, 31300 Toulouse, France
| | - R Nicollas
- Service d'ORL, CHU La Timone, AP-HM, 13005 Marseille, France
| | - S Pondaven
- Service d'ORL, hôpital Clocheville, CHU de Tours, 37000 Tours, France
| | - J-P Stahl
- Service d'infectiologie, CHU de Grenoble, 38700 Grenoble, France
| | - C Wood
- Service d'algologie, CHU Dupuytren, 87000 Limoges, France
| | - V Couloigner
- Service d'ORL, hôpital Necker-Enfants-Malades, AP-HP, 75015 Paris, France.
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Charrière EF, Tourniaire B, Gautier J, Colin E. P-226 – Prescription hors AMM en consultation de la douleur chronique de l'enfant. Arch Pediatr 2015. [DOI: 10.1016/s0929-693x(15)30406-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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