Tags

Type your tag names separated by a space and hit enter

Prophylaxis with acetaminophen or ibuprofen for prevention of local reactions to the fifth diphtheria-tetanus toxoids-acellular pertussis vaccination: a randomized, controlled trial.

Abstract

BACKGROUND

The frequency of local vaccination reactions increases with successive doses of diphtheria-tetanus toxoids-acellular pertussis (DTaP) vaccine, and local reactions occur for the majority of children receiving the fifth DTaP vaccination. It is not known whether these reactions can be prevented with prophylactic use of acetaminophen or ibuprofen.

METHODS

In this 3-group, randomized, blinded, controlled trial, 372 children were assigned randomly, in a 2:2:1 ratio, to receive 3 doses of acetaminophen, ibuprofen, or placebo. The first dose of study medication was administered within 2 hours before the fifth DTaP vaccination, and the remaining 2 doses were given at 6-hour intervals. The primary outcome measures included a local reaction with an area of redness or discoloration > or =5 cm in diameter on the evening of or during the 2 days after vaccination, an increase in mid-limb circumference of > or =2 cm on the evening of or during the 2 days after vaccination, and a persistent local reaction, defined as an area of redness or discoloration present on the third day after vaccination.

RESULTS

Local reactions with a > or =5-cm area of redness or discoloration were reported for 35% of children in the placebo group, compared with 33% of children in the acetaminophen group and 37% of children in the ibuprofen group. There was also no significant difference between the placebo and treatment groups in the proportions of children with a > or =2-cm increase in mid-limb circumference or with a persistent local reaction.

CONCLUSIONS

We did not find evidence that prophylaxis with acetaminophen or ibuprofen offers a clinically significant benefit in prevention of local reactions to the fifth DTaP vaccination.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Center for Health Studies, Group Health Cooperative, Seattle, WA 98101, USA. jackson.l@ghc.org

    , , , , , ,

    Source

    Pediatrics 117:3 2006 Mar pg 620-5

    MeSH

    Acetaminophen
    Analgesics, Non-Narcotic
    Anti-Inflammatory Agents, Non-Steroidal
    Child
    Child, Preschool
    Diphtheria-Tetanus-acellular Pertussis Vaccines
    Double-Blind Method
    Erythema
    Humans
    Ibuprofen
    Immunization, Secondary
    Pain

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    16510639

    Citation

    Jackson, Lisa A., et al. "Prophylaxis With Acetaminophen or Ibuprofen for Prevention of Local Reactions to the Fifth Diphtheria-tetanus Toxoids-acellular Pertussis Vaccination: a Randomized, Controlled Trial." Pediatrics, vol. 117, no. 3, 2006, pp. 620-5.
    Jackson LA, Dunstan M, Starkovich P, et al. Prophylaxis with acetaminophen or ibuprofen for prevention of local reactions to the fifth diphtheria-tetanus toxoids-acellular pertussis vaccination: a randomized, controlled trial. Pediatrics. 2006;117(3):620-5.
    Jackson, L. A., Dunstan, M., Starkovich, P., Dunn, J., Yu, O., Nelson, J. C., ... Zavitkovsky, A. (2006). Prophylaxis with acetaminophen or ibuprofen for prevention of local reactions to the fifth diphtheria-tetanus toxoids-acellular pertussis vaccination: a randomized, controlled trial. Pediatrics, 117(3), pp. 620-5.
    Jackson LA, et al. Prophylaxis With Acetaminophen or Ibuprofen for Prevention of Local Reactions to the Fifth Diphtheria-tetanus Toxoids-acellular Pertussis Vaccination: a Randomized, Controlled Trial. Pediatrics. 2006;117(3):620-5. PubMed PMID: 16510639.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Prophylaxis with acetaminophen or ibuprofen for prevention of local reactions to the fifth diphtheria-tetanus toxoids-acellular pertussis vaccination: a randomized, controlled trial. AU - Jackson,Lisa A, AU - Dunstan,Maya, AU - Starkovich,Patty, AU - Dunn,John, AU - Yu,Onchee, AU - Nelson,Jennifer C, AU - Rees,Thom, AU - Zavitkovsky,Ann, PY - 2006/3/3/pubmed PY - 2006/3/23/medline PY - 2006/3/3/entrez SP - 620 EP - 5 JF - Pediatrics JO - Pediatrics VL - 117 IS - 3 N2 - BACKGROUND: The frequency of local vaccination reactions increases with successive doses of diphtheria-tetanus toxoids-acellular pertussis (DTaP) vaccine, and local reactions occur for the majority of children receiving the fifth DTaP vaccination. It is not known whether these reactions can be prevented with prophylactic use of acetaminophen or ibuprofen. METHODS: In this 3-group, randomized, blinded, controlled trial, 372 children were assigned randomly, in a 2:2:1 ratio, to receive 3 doses of acetaminophen, ibuprofen, or placebo. The first dose of study medication was administered within 2 hours before the fifth DTaP vaccination, and the remaining 2 doses were given at 6-hour intervals. The primary outcome measures included a local reaction with an area of redness or discoloration > or =5 cm in diameter on the evening of or during the 2 days after vaccination, an increase in mid-limb circumference of > or =2 cm on the evening of or during the 2 days after vaccination, and a persistent local reaction, defined as an area of redness or discoloration present on the third day after vaccination. RESULTS: Local reactions with a > or =5-cm area of redness or discoloration were reported for 35% of children in the placebo group, compared with 33% of children in the acetaminophen group and 37% of children in the ibuprofen group. There was also no significant difference between the placebo and treatment groups in the proportions of children with a > or =2-cm increase in mid-limb circumference or with a persistent local reaction. CONCLUSIONS: We did not find evidence that prophylaxis with acetaminophen or ibuprofen offers a clinically significant benefit in prevention of local reactions to the fifth DTaP vaccination. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/16510639/Prophylaxis_with_acetaminophen_or_ibuprofen_for_prevention_of_local_reactions_to_the_fifth_diphtheria_tetanus_toxoids_acellular_pertussis_vaccination:_a_randomized_controlled_trial_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=16510639 DB - PRIME DP - Unbound Medicine ER -