Prospective observational study of adverse drug reactions to diclofenac in children.
OBJECTIVE
The aim of this study was to investigate the type of common (occurring in >1% of patients) adverse reactions caused by diclofenac when given to children for acute pain.


METHODS
A prospective observational study was undertaken on paediatric surgical patents aged < or =12 years at Great Ormond Street and University College London Hospitals. All adverse events were recorded, and causality assessment used to judge the likelihood of them being due to diclofenac. Prospective recruitment meant not all patients were prescribed diclofenac, allowing an analysis of utilization. Causality of all serious adverse events was reviewed by an expert panel.


RESULTS
Children prescribed diclofenac were significantly older, and stayed in hospital for shorter periods than those who were not. Diclofenac was not avoided in asthmatic patients. Data on 380 children showed they suffer similar types of nonserious adverse reactions to adults. The incidence (95% confidence interval) of rash was 0.8% (0.016, 2.3); minor central nervous system disturbance 0.5% (0.06, 1.9); rectal irritation with suppositories 0.3% (0.009, 1.9); and diarrhoea 0.3% (0.007, 1.5). No serious adverse event was judged to be caused by diclofenac, meaning the incidence of serious adverse reactions to diclofenac in children is <0.8%.


CONCLUSIONS
Children given diclofenac for acute pain appeared to suffer similar types of adverse reactions to adults; the incidence of serious adverse reaction is <0.8%.
Standing
Joseph F
JF
Great Ormond Street Hospital for Children, School of Pharmacy, University of London, London, UK. joseph.standing@farmbio.uu.se
Ooi
Kuan
K
Keady
Simon
S
Howard
Richard F
RF
Savage
Imogen
I
Wong
Ian C K
IC
D016907:Adverse Drug Reaction Reporting Systems; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D004008:Diclofenac / Q000009:adverse effects*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000139:chemically induced*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D010146:Pain / Q000188:drug therapy*; D011446:Prospective Studies
D004008:Diclofenac
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