van den Anker J N
Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, USA.
Int J Clin Pract Suppl. 2013 Jan(178):26-32. doi: 10.1111/ijcp.12056.
Fever and pain in children, especially associated with infections, such as otitis media, are very common. In paediatric populations, ibuprofen and paracetamol (acetaminophen) are both commonly used over-the-counter medicines for the management of fever or mild-to-moderate pain associated with sore throat, otitis media, toothache, earache and headache. Widespread use of ibuprofen and paracetamol has shown that they are both effective and generally well tolerated in the reduction in paediatric fever and pain. However, ibuprofen has the advantage of less frequent dosing (every 6-8 h vs. every 4 h for paracetamol) and its longer duration of action makes it a suitable alternative to paracetamol. In comparative trials, ibuprofen has been shown to be at least as effective as paracetamol as an analgesic and more effective as an antipyretic. The safety profile of ibuprofen is comparable to that of paracetamol if both drugs are used appropriately with the correct dosing regimens. However, in the overdose situation, the toxicity of paracetamol is not only reached much earlier, but is also more severe and more difficult to manage as compared with an overdose of ibuprofen. There is clearly a need for advanced studies to investigate the safety of these medications in paediatric populations of different ages and especially during prolonged use. Finally, the recently reported association between frequency and severity of asthma and paracetamol use needs urgent additional investigations.
儿童发热和疼痛，尤其是与感染相关的，如中耳炎，非常常见。在儿科人群中，布洛芬和对乙酰氨基酚（扑热息痛）都是常用的非处方药，用于治疗与喉咙痛、中耳炎、牙痛、耳痛和头痛相关的发热或轻至中度疼痛。布洛芬和对乙酰氨基酚的广泛使用表明，它们在降低儿科发热和疼痛方面都是有效的，并且通常耐受性良好。然而，布洛芬具有给药频率较低的优势（每6 - 8小时一次，而对乙酰氨基酚为每4小时一次），其较长的作用持续时间使其成为对乙酰氨基酚的合适替代品。在比较试验中，布洛芬已被证明作为镇痛药至少与对乙酰氨基酚一样有效，作为退热药则更有效。如果两种药物都以正确的给药方案适当使用，布洛芬的安全性与对乙酰氨基酚相当。然而，在过量用药的情况下，与过量服用布洛芬相比，对乙酰氨基酚的毒性不仅更早出现，而且更严重，更难处理。显然需要进行进一步的研究，以调查这些药物在不同年龄段儿科人群中的安全性，特别是在长期使用期间。最后，最近报道的哮喘频率和严重程度与使用对乙酰氨基酚之间的关联需要紧急进行更多调查。
