Nonsteroidal anti-Inflammatory drugs: A survey of practices and concerns of pediatric medical and surgical specialists and a summary of available safety data

Objectives: to examine the prescribing habits of nsaids among pediatric medical and surgical practitioners,and to examine concerns and barriers to their use.methods: a sample of 1289 pediatricians,pediatric rheumatologists,sports medicine physicians,pediatric surgeons and pediatric orthopedic surgeons in the united states and canada were sent an email link to a 22-question web-based survey.results: 338 surveys (28%) were completed,84 were undeliverable. of all respondents,164 (50%) had never prescribed a selective cyclooxygenase-2 (cox-2) nsaid. the most common reasons for ever prescribing an nsaid were musculoskeletal pain,soft-tissue injury,fever,arthritis,fracture,and headache. compared to traditional nsaids,selective cox-2 nsaids were believed to be as safe (42%) or safer (24%); have equal (52%) to greater efficacy (20%) for pain; have equal (59%) to greater efficacy (15%) for inflammation; and have equal (39%) to improved (44%) tolerability. pediatric rheumatologists reported significantly more frequent abdominal pain (81% vs. 23%),epistaxis (13% vs. 2%),easy bruising (64% vs. 8%),headaches (21% vs. 1%) and fatigue (12% vs. 1%) for traditional nsaids than for selective cox-2 nsaids. prescribing habits of nsaids have changed since the voluntary withdrawal of rofecoxib and valdecoxib; 3% of pediatric rheumatologists reported giving fewer traditional nsaid prescriptions,and while 57% reported giving fewer selective cox-2 nsaids,26% reported that they no longer prescribed these medications.conclusions: traditional and selective cox-2 nsaids were perceived as safe by pediatric specialists. the data were compared to the published pediatric safety literature. © 2010 levy and imundo; licensee biomed central ltd.