title: Association of Acetaminophen and Ibuprofen Use With Wheezing in Children With Acute Febrile Illness.
abstract: BACKGROUND
  Many infants and children receive acetaminophen and/or ibuprofen during febrile illness. Previously, some studies have linked acetaminophen and ibuprofen use to wheezing and exacerbation of asthma symptoms in infants and children.
  
  
  OBJECTIVE
  To assess whether acetaminophen or ibuprofen use are associated with wheezing in children presenting to the emergency department (ED) with febrile illness.
  
  
  METHODS
  This was a cross-sectional study of children who presented with fever to the pediatric ED between 2009 and 2013. The data were collected from questionnaires and from the children's medical files. Patients with wheezing in the ED were compared with nonwheezing patients. Associations between medication use and wheezing were assessed using univariate and multivariate analyses. The multivariate analysis adjusted for potential confounding variables (ie, age, atopic dermatitis, allergies, smoking, antibiotics use, etc) via propensity scores.
  
  
  RESULTS
  During the study period, 534 children admitted to the ED met our inclusion criteria, of whom 347 (65%) were included in the study. The use of acetaminophen was similar in children diagnosed with wheezing compared with those without wheezing (n = 39, 81.3%, vs n = 229, 82.7%, respectively). Ibuprofen use was significantly lower in children diagnosed with wheezing (n = 22, 52.4%, vs n = 168, 69.4%, respectively). In multivariate analysis, acetaminophen was not associated with a higher rate of wheezing during acute febrile illness (adjusted odds ratio [OR] = 0.76, 95% CI = 0.24- 2.39), whereas ibuprofen was associated with a lower risk of wheezing (adjusted OR = 0.36, 95% CI = 0.13-0.96).
  
  
  CONCLUSIONS
  Our study suggests that acetaminophen and ibuprofen are not associated with increased risk for wheezing during acute febrile illness.
authors: 1 The Hebrew University of Jerusalem, Jerusalem, Israel.
authors: Ilan
authors: I
authors: Matok
authors: 2 Assaf-Harofeh Medical Center, Zerifin, Israel.|3 Sackler Faculty of Medicine,Tel Aviv University, Tel Aviv, Israel.
authors: Arnon
authors: A
authors: Elizur
authors: 1 The Hebrew University of Jerusalem, Jerusalem, Israel.
authors: Amichai
authors: A
authors: Perlman
authors: 3 Sackler Faculty of Medicine,Tel Aviv University, Tel Aviv, Israel.
authors: Shani
authors: S
authors: Ganor
authors: 4 Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel.
authors: Hagai
authors: H
authors: Levine
authors: 2 Assaf-Harofeh Medical Center, Zerifin, Israel.|3 Sackler Faculty of Medicine,Tel Aviv University, Tel Aviv, Israel.
authors: Eran
authors: E
authors: Kozer
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects; D058633:Antipyretics / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000139:chemically induced / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D005334:Fever / Q000188:drug therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D007223:Infant; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D012135:Respiratory Sounds / Q000187:drug effects*; D012306:Risk; D011795:Surveys and Questionnaires
chemical_list: D018712:Analgesics, Non-Narcotic; D058633:Antipyretics; D000082:Acetaminophen; D007052:Ibuprofen
keywords: acetaminophen; antipyretics; asthma; nonsteroidal anti-inflammatory drugs; pediatrics