Ibuprofen is a non-steroidal anti-inflammatory drug prescribed for treating fever and pain by medical professionals. Though it is the commonly prescribed medicine for fever, you should never administer this medicine to children infected with chickenpox.
There is an increased risk of streptococcal infection after chickenpox and necrotizing fasciitis after treatment by ibuprofen. There is also the risk of dehydration, gastroduodenal and hemorrhagic adverse reactions. It causes inflammation of the skin and even septicemia or blood poisoning and acute renal failure in severe conditions.12
Effects Of Ibuprofen On Kids With Chicken Pox
1. Reduces Immune Function
Pediatricians prescribe ibuprofen to block high temperatures in children when fevers start. This medicine reduces fever, pain, and inflammation. Though ibuprofen relieves pain and reduces fever, it inhibits the white cell production of antibodies by up to 50 percent and adversely affects the leukocyte function in vitro. White blood cells play an important role in helping the immune system of the body fight the infection.3
Non-steroidal anti-inflammatory drugs like ibuprofen may have an adverse effect on neutrophil killing and cell mediated immunity with conditions like chickenpox. Hence, ibuprofen can mask the symptoms of an early infection resulting in the delayed diagnosis of the disease and advancement of severe disease and complications.
2. Streptococcal Infections, Necrosis, And Pneumonia
There is a well-recognized risk of streptococcal infections after the occurrence of chickenpox. Intake of ibuprofen before the commencement of treatment for chicken pox can complicate the condition. Using ibuprofen with chicken pox increases the chance of developing necrotizing fasciitis (flesh-eating bacteria) which is an infection that results in the death of the body’s soft tissue since it reduces the child’s immune function.
The children who took ibuprofen before hospitalization had a longer duration of symptoms associated with secondary infection than those who did not take the medicine. These secondary risks can arise because the body’s natural immune process is impaired or the effects of ibuprofen mask the symptoms of secondary infection.4
Complications due to secondary skin infections though common in children can result in severe infections like the inflammation of the lung causing pneumonia which requires immediate medical intervention. Streptococcal infection carries with it a high risk of death. The use of Ibuprofen can increase the risk of invasive group A strep (GAS) disease that includes necrotizing fasciitis and streptococcal toxic shock syndrome which is a rapidly progressing infection causing sudden onset of shock, organ failure, and injury.5
3. Dehydration And Multi-Organ Failure
A child with chickenpox may not feel like eating or drinking much especially if he/she has blisters in his or her mouth. Hence, the child is at risk for developing complications like dehydration. Use of ibuprofen for children with dehydration should be avoided due to possible renal toxicity.6
It can also lead to developing severe hemorrhagic rashes which bruise and bleed into the skin. It can cause gastrointestinal bleeds and perforations. Hemorrhagic varicella with multi-organ system failure is rare in healthy children, but its outcome is usually fatal.7
4. Acute Kidney Injury And Septicemia
Ibuprofen can also induce acute kidney injury in dehydrated children independent of the extent of the dehydration.8 The streptococcal complications that can aggravate the condition with the use of ibuprofen can also lead to bacterial sepsis or septicemia associated with a high mortality rate. With the high risk of incidence of necrotizing fasciitis, the severely progressing bacterial infection can cause septic shock and develop lesions of the pelvis and abdominal wall causing infection in the internal organs.9
Ibuprofen, though a relatively safe non-steroidal anti-inflammatory agent administered to children for fever and pain, should be avoided for chickenpox infection because of the mentioned complications.
|↑1||Leroy, S., A. Mosca, C. Landre-Peigne, M. A. Cosson, and G. Pons. “Ibuprofen in childhood: evidence-based review of efficacy and safety.” Archives de pediatrie: organe officiel de la Societe francaise de pediatrie 14, no. 5 (2007): 477-484.|
|↑2||Hale, Cynthia M., and Jacqueline A. Polder. The ABCs of Safe & Healthy Child Care: A Handbook for Child Care Providers. DIANE Publishing, 2000.|
|↑3||White, B., and Sunny Mavor. “Fever in Children: A Blessing in Disguise.” (1999).|
|↑4||Voss, Lesley. “Necrotising fasciitis associated with non-steroidal anti-inflammatory drugs.” Prescriber UpdateFebruary 20 (2001): 4-7.|
|↑5||Stevens, Dennis L. “Could nonsteroidal anti-inflammatory drugs (NSAIDs) enhance the progression of bacterial infections to toxic shock syndrome?.” Clinical Infectious Diseases 21, no. 4 (1995): 977-980.|
|↑6||Yellon, Robert F., Margaret A. Kenna, Franklyn P. Cladis, William Mcghee, and Peter J. Davis. “What is the best non‐codeine postadenotonsillectomy pain management for children?.” The Laryngoscope 124, no. 8 (2014): 1737-1738.|
|↑7||Wolfson, Allan B., Gregory W. Hendey, Louis J. Ling, Carlo L. Rosen, Jeffrey J. Schaider, and Ghazala Q. Sharieff. Harwood-Nuss’ clinical practice of emergency medicine. Lippincott Williams & Wilkins, 2012.|
|↑8||Balestracci, Alejandro, Mauricio Ezquer, María Eugenia Elmo, Andrea Molini, Claudia Thorel, Milagros Torrents, and Ismael Toledo. “Ibuprofen-associated acute kidney injury in dehydrated children with acute gastroenteritis.” Pediatric nephrology 30, no. 10 (2015): 1873-1878.|
|↑9||Billiemaz, K., M. P. Lavocat, G. Teyssier, Y. Chavrier, D. Allard, and F. Varlet. “Varicella complicated with necrotizing fasciitis caused by group A hemolytic Streptococcus.” Archives de pediatrie: organe officiel de la Societe francaise de pediatrie 9, no. 3 (2002): 262-265.|