Mr. Editor:

Nonsteroidal anti-inflammatory drugs (NSAIDs) constitute a pharmacological family that shares antipyretic, analgesic and logically anti-inflammatory effects through their ability to inhibit the production of prostaglandin. The term non-steroidal refers to its effects similar to corticosteroids, but without the secondary consequences that are characteristic of steroids. The drugs that are included are varied, the most traditional being Ibuprofen, ASA, ketoprofen, ketorolac, Naproxen, among others⁽¹⁾.

NSAIDs, as a whole, are ideal for treating pain, especially when it is secondary to inflammation. The free sale of some of them to the user, offers very satisfactory results in different types of episodes and therefore, currently, is one of the most prescribed and consumed pharmacological groups worldwide with a tendency to increase in the future due to the extension of its indications⁽²⁾. Due to this and consequently, it is necessary to know the safety aspects of NSAIDs in order to rationalize their consumption and prevent induced pathologies.

In this context, this year, the French Agency for the Safety of Medicines and Health Products (ANSM) presented a report motivated by the appearance of bacterial infections and found a possible association with the use of Ibuprofen and Ketoprofen, particularly in areas such as skin and other soft tissues such as pleuropulmonary and neurological. In France, various scientific societies are working on this issue, of which two of them consider it an important problem for public health. Studies suggest an association between NSAID exposure and an increased risk of pleuropulmonary complications, for example; pleural empyema (Odds rattio: 2.79); they also found an increased risk of suffering significant necrotizing soft tissue infections in cases of chickenpox (risk between 3.9-10.2)⁽³⁾.

The experimental data point to 3 phenomena that generate the underlying cause of the consumption of NSAIDs such as the masking of the symptoms of the infection, immunomodulatory effects (the recruitment of neutrophils is altered), and the spread of streptococcal infection (in particular with the use of ibuprofen). Experimental studies point to the existence of a real link that reaches levels of evidence that are worrying and high enough to take preventive measures⁽³⁾.

Considering that these are important preventable pathologies, and that, in certain cases they can lead to death, it is necessary that the authorities take actions in the framework of prevention, control of indiscriminate sale, and finally, as a recommendation to the professionals of the health, take great care in the prescription and consumption of Ibuprofen and Ketoprofen, taking into account that there are other less harmful alternatives.

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Authorship contributions: The authors participated in the generation, collection of information, writing and final version of the original article.
Financing: Self-financed.
Conflict of interest: The authors declare that they have no conflicts of interest in the publication of this article.
Received: October 1, 2019
Approved: February 7, 2020

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Correspondence: Miguel Ángel Poma.
Address: Calle 10 N348 Urb Monterrico Norte, San Borja, Lima-Perú.
Telephone: +51 964 780 352
E-mail: mapoma@pucp.pe

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