title: Use of high-dose ibuprofen in a pediatric cystic fibrosis center.
abstract: Despite its apparent benefits, high-dose ibuprofen has been infrequently applied to children with cystic fibrosis. We have noted a decrease in the use of high-dose ibuprofen at our pediatric cystic fibrosis center during the past decade. In this retrospective study, we examined our clinical experience with high-dose ibuprofen and other anti-inflammatory drugs in cystic fibrosis patients. The medical records of all patients, ages 5 to 18 years, followed at the cystic fibrosis center from 1995 to 2002, were reviewed and children were classified into two cohorts: ibuprofen-treated and untreated groups. Patterns of ibuprofen use and pharmacokinetics in treated patients, and for patients who discontinued ibuprofen, the reasons for stopping the medication, including adverse effects, were assessed. Pulmonary function decline and hospitalization rates for each group were compared, examining both intent to treat and patients who continued therapy for at least 4 years. Nearly half of the patients in our pediatric cystic fibrosis center who were prescribed with high-dose ibuprofen discontinued therapy due to adverse events, not because of poor adherence or patient choice. Neither use of high-dose ibuprofen nor its cessation resulted in a significant change in the rate of decline in pulmonary function or influenced hospitalization rates.
authors.affiliation: Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, United States.
authors.forename: Preston Blain
authors.initials: PB
authors.lastname: Fennell
authors.forename: Jane
authors.initials: J
authors.lastname: Quante
authors.forename: Karen
authors.initials: K
authors.lastname: Wilson
authors.forename: Mary
authors.initials: M
authors.lastname: Boyle
authors.forename: Robert
authors.initials: R
authors.lastname: Strunk
authors.forename: Thomas
authors.initials: T
authors.lastname: Ferkol
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006760:Hospitalization; D006801:Humans; D007052:Ibuprofen / Q000493:pharmacokinetics / Q000627:therapeutic use*; D007902:Length of Stay; D008171:Lung Diseases / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D010349:Patient Compliance; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen