Table 1.
Studies exploring the impact of pre-hospital exposure to NSAIDs in lower respiratory tract infections.
| Author; Study Period | Population (Number of Patients); Country | Study Drug | Care Setting | Study Design | Comment |
|---|---|---|---|---|---|
| Francois [45] 1995–2003 | Children (n = 767), CAP, France | Ibuprofen | Hospital ward | Retrospective case-control | Recent NSAID exposure was an independent risk factor of pleural empyema (OR 2.6 (1.5–4.4)) |
| Byington [46] 1993–1999 | Children (n = 540), CAP, United States | Ibuprofen | Hospital ward | Retrospective case-control | Recent NSAID exposure was an independent risk factor of pleural empyema (OR 4.0 (2.5–6.5)) |
| Voiriot [47] 2002–2006 | Adults (n = 90), CAP, France | NSAIDs | ICU | Prospective cohort | Recent NSAID exposure was an independent risk factor of pleuropulmonary complications (pleural empyema, excavation) (OR 8.1 (2.3–28)) |
| Messika [48] 1997–2009 | Adults (n = 106), pneumococcal CAP, France | NSAIDs | ICU | Historical cohort | Recent NSAID exposure was associated with a higher risk of pleuropulmonary complications (pleural empyema, excavation) (OR 5.8 (2.0–17)) |
| Elemraid [49] 2009–2011 | Children (n = 160), CAP, UK | Ibuprofen | Hospital ward | Prospective case-control | Recent NSAID exposure was involved in 82% of cases with pleural empyema, compared to 46% of cases without complications (OR 1.9 (0.8–3.2)) |
| Le Bourgeois [50] * 2006–2009 | Children (n = 83), viral LRTI, France | NSAIDs | Hospital ward | Prospective case-control | Recent NSAID exposure was an independent risk factor of pleural empyema (OR 2.8 (1.4–5.6)) |
| Kotsiou [51] 2015–2016 | Adults (n = 57), CAP, Greece | NSAIDs | Hospital ward | Prospective cohort | Pre-hospital NSAID use for more than 6 days was associated with a prolonged hospitalization duration |
| Basille [52] 2008–2013 | Adults (n = 221), CAP, France | NSAIDs | Hospital ward | Prospective cohort | Recent NSAID exposure was an independent risk factor of pleural empyema (OR 2.6 (1.02–6.6)) |
| Krenke [53] 2012–2014 | Children (n = 203), CAP, Poland | Ibuprofen | Hospital ward | Prospective cohort | A dose–effect relationship was found: exposure to a cumulative dose of ibuprofen higher than 78 mg/kg was significantly associated with an increased risk of pleuropulmonary complications, such as parapneumonic pleural effusion, pleural empyema, necrotizing pneumonia and pulmonary abscess (OR 2.5 (1.3–4.9)) |
| Basille [54] * 1997–2011 | Adults (n = 59,250), CAP, Denmark | NSAIDs | Hospital ward | Registry-based | NSAID exposure was associated with pleural empyema and/or lung abscess (RR 1.81 (1.60–2.05)) |
Abbreviations: CAP = community acquired pneumonia; ICU = intensive care unit; LRTI = lower respiratory tract infections; n = number; NSAIDs = non-steroidal anti-inflammatory drugs; OR = odds ratio; RR = rate ratio. Odds ratio (OR) and rate ratio (RR) are expressed as values at 95% confidence intervals. * Studies that took into account the protopathic bias.