Ketoprofen and ibuprofen, the two best-selling anti-inflammatory medications that can be taken without warning in case of fever with headache or throat, could promote serious infectious complications, warns the Medicines Agency that calls for "vigilance".
According to the results of a survey, "in 18 years, from 2000 to 2018, 337 cases of infectious complications including 32 deaths were listed for ibuprofen and 46 cases including ten deaths with ketoprofen," says AFP. Dr. Philippe Vella, director of analgesic drugs at ANSM. Ibuprofen (Nurofen, Advil, Upfen Antarene, etc.) and ketoprofen (Profenid, Toprec, Ketum) belong to a family of drugs, nonsteroidal anti-inflammatory drugs (NSAIDs), which were already reported for serious infectious complications. Hence this survey, which had been entrusted by the ANSM to the regional pharmacovigilance centers of Tours and Marseille.
Only the most serious cases in children and adults (often young) without a particular risk factor, such as being immunocompromised, were included in this survey. These are severe infections that lead to hospitalizations, sequelae and death. They affect the skin and soft tissue such as "necrotizing fasciitis", an infection due to a germ (essentially a streptococcus) nicknamed "flesh-eating" bacteria, source of amputation and death. It can also be septicemia ("sepsis"), pneumonia complicated abscess, pleurisy, brain abscess or ENT infections reaching the chest (mediastinitis).
"The findings of this survey suggest the aggravating role of these NSAIDs in case of infection"
These infectious complications (mainly due to two bacteria, streptococcus or pneumococcus) were observed after very short treatment duration (2 to 3 days), including when combined with antibiotic therapy. "The findings of this survey suggest the aggravating role of these NSAIDs in case of infection," especially those due to streptococcus, notes the ANSM which indicates to have shared these results with its European counterparts. The investigation also shows that the use of NSAID persists in cases of chickenpox while they must be avoided in favor of paracetamol, otherwise risk of serious bacterial skin destruction.
These anti-inflammatories should be used "at the lowest effective dose, for the shortest duration", ie "not more than 3 days in case of fever and 5 days in case of pain". "If the symptoms worsen, you have to talk to your pharmacist and see your doctor," advises Dr. Vella. Another rule, do not take at the same time two drugs of this large family of NSAIDs (naproxen, diclofenac ...), sold under various names.