Antipyretic drug use in children in French office based medical practice.
OBJECTIVE
To analyse antipyretics (APs) prescriptions profile in children, particularly the frequency of AP combinations.


METHODS
APs (acetylsalicylic acid, paracetamol, ibuprofen or ketoprofen) prescribed to children below 12 years and refunded by a public health insurer in 2003, throughout France, were examined.


RESULTS
A total of 513 034 prescriptions were refunded for 240 720 children. The mean number of AP prescriptions per child was the highest in children aged 6 months to 2 years. Paracetamol was the main AP prescribed, but its prescription declined with age, from 90.8% below 3 months old to 57.4% between 6 and 12 years old. Ibuprofen-only prescriptions were rare below 3 months and maximal between 2 and 6 years. The ibuprofen/paracetamol combination was prescribed from 6 months old, and its frequency was maximal between 2 and 6 years old (21.7%).


CONCLUSIONS
The clear predominance of paracetamol prescriptions suggests that French prescribers are relatively aware of the relative risk-benefit ratio of the different APs. Studies are required to determine if the APs are prescribed to be used alternately or when a monotherapy fails. Guidelines to manage fever in children are needed in France to restrict APs combination to the case of paracetamol failure.
Deligne
Jean
J
CANAM, Caisse Nationale d'Assurance Maladie des Professions Indépendantes, France.
Grimaldi
Lamiae
L
Jonville-Béra
Annie-Pierre
AP
Giraudeau
Bruno
B
Blum-Boisgard
Claudine
C
Autret-Leca
Elisabeth
E
D000082:Acetaminophen / Q000009:adverse effects / Q000627:therapeutic use; D000367:Age Factors; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000627:therapeutic use*; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D005334:Fever / Q000188:drug therapy*; D005602:France; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D007660:Ketoprofen / Q000009:adverse effects / Q000627:therapeutic use; D010824:Physicians' Offices; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen; D007660:Ketoprofen; D001241:Aspirin; D007052:Ibuprofen