Deligne Jean, Grimaldi Lamiae, Jonville-Béra Annie-Pierre, Giraudeau Bruno, Blum-Boisgard Claudine, Autret-Leca Elisabeth
CANAM, Caisse Nationale d'Assurance Maladie des Professions Indépendantes, France.
Pharmacoepidemiol Drug Saf. 2007 Jul;16(7):812-7. doi: 10.1002/pds.1422.
To analyse antipyretics (APs) prescriptions profile in children, particularly the frequency of AP combinations.
APs (acetylsalicylic acid, paracetamol, ibuprofen or ketoprofen) prescribed to children below 12 years and refunded by a public health insurer in 2003, throughout France, were examined.
A total of 513 034 prescriptions were refunded for 240 720 children. The mean number of AP prescriptions per child was the highest in children aged 6 months to 2 years. Paracetamol was the main AP prescribed, but its prescription declined with age, from 90.8% below 3 months old to 57.4% between 6 and 12 years old. Ibuprofen-only prescriptions were rare below 3 months and maximal between 2 and 6 years. The ibuprofen/paracetamol combination was prescribed from 6 months old, and its frequency was maximal between 2 and 6 years old (21.7%).
The clear predominance of paracetamol prescriptions suggests that French prescribers are relatively aware of the relative risk-benefit ratio of the different APs. Studies are required to determine if the APs are prescribed to be used alternately or when a monotherapy fails. Guidelines to manage fever in children are needed in France to restrict APs combination to the case of paracetamol failure.
分析儿童退烧药（APs）的处方情况，尤其是APs联合用药的频率。
对2003年法国全国范围内12岁以下儿童开具的、由公共健康保险公司报销的APs（乙酰水杨酸、对乙酰氨基酚、布洛芬或酮洛芬）进行审查。
共为240720名儿童报销了513034张处方。每个儿童的AP处方平均数在6个月至2岁的儿童中最高。对乙酰氨基酚是主要开具的AP，但随着年龄增长其处方量下降，从3个月以下儿童中的90.8%降至6至12岁儿童中的57.4%。仅开具布洛芬的处方在3个月以下儿童中很少见，在2至6岁儿童中最多。布洛芬/对乙酰氨基酚联合用药从6个月开始开具，其频率在2至6岁儿童中最高（21.7%）。
对乙酰氨基酚处方明显占主导地位，这表明法国的处方医生相对了解不同APs的相对风险效益比。需要进行研究以确定APs是交替使用还是在单一疗法失败时使用。法国需要制定儿童发热管理指南，将APs联合用药限制在对乙酰氨基酚治疗失败的情况下。
