TABLE 3.
Summary of findings: Ibuprofen compared to Placebo/Other NSAIDs for Pediatric ARTI
|
Patient or population: Pediatric ARTI Intervention: Ibuprofen Comparison: Placebo/Other NSAIDs | ||||||
|---|---|---|---|---|---|---|
|
Outcome № of participants (studies) |
Relative effect (95% CI) |
Anticipated absolute effects (95% CI) | Certainty | What happens | ||
| Difference | ||||||
|
Fever № of participants: 483 (4 RCTs) |
– | not pooled | – | not pooled |
⨁⨁⨁⨁ HIGH |
Ibuprofen results in a large reduction in fever. |
|
Cough follow up: 2 days № of participants: 52 (1 RCT) |
RR 0.79 (0.60 to 1.06) |
89.3% |
70.5% (53.6 to 94.6) |
18.7% fewer (35.7 fewer to 5.4 more) |
⨁⨁◯◯ LOW a,b |
Ibuprofen likely results in little to no difference in cough. small effect is seen here may be due to additional Anti‐biotics. |
|
Sore Throat follow up: 2 days № of participants: 153 (1 RCT) |
RR 1.68 (1.27 to 2.23) |
44.7% |
75.2% (56.8 to 99.8) |
30.4% more (12.1 more to 55 more) |
⨁⨁⨁◯ MODERATE b |
Although Penicillin is used in both groups, the Ibuprofen group had a significant reduction in sore throat. Ibuprofen likely results in a large decrease in pediatric sore Throat. |
| ARDS ‐ not reported | – | – | – | – | – | No studies investigated the efficacy of viral ARDS in the pediatric population. |
|
Length of Stay follow up: 5 days № of participants: 104 (1 RCT) |
RR 0.83 (0.49 to 1.38) |
40.4% |
33.5% (19.8 to 55.7) |
6.9% fewer (20.6 fewer to 15.3 more) |
⨁⨁⨁◯ MODERATE c |
No significant difference in the recovery of the pediatric common cold was observed between Ibuprofen and Paracetamol. |
|
Gastrointestinal adverse events (GI AE) № of participants: 579 (4 RCTs) |
not pooled | 0.0% | not pooled | not pooled |
⨁⨁⨁◯ MODERATE d |
The overall incidence of gastrointestinal discomfort is large in children. In short periods of use, Ibuprofen does not significantly cause higher gastrointestinal adverse events than Dexibuprofen or Paracetamol. |
GRADE Working Group grades of evidence:
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect
Explanations: a. no blinding of participants and personnel; b. Additional use of Anti‐Biotics; c. small sample size and d. All 4 studies are against other interventions rather than placebo.
Abbreviations: CI, Confidence interval; RR, Risk ratio.
The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).