Drug use and upper gastrointestinal complications in children: a case–control study
Identifieur interne : 000240 ( Istex/Corpus ); précédent : 000239; suivant : 000241Drug use and upper gastrointestinal complications in children: a case–control study
Auteurs : Manuela Bianciotto ; Elena Chiappini ; Irene Raffaldi ; Clara Gabiano ; Pier-Angelo Tovo ; Sara Sollai ; Maurizio De Martino ; Francesco Mannelli ; Vincenzo Tipo ; Roberto Da Cas ; Giuseppe Traversa ; Francesca Menniti-Ippolito ; Francesca Menniti-Ippolito ; Roberto Da Cas ; Luciano Sagliocca ; Giuseppe Traversa ; Fernanda Ferrazin ; Carmela Santuccio ; Loriana Tartaglia ; Francesco Trotta ; Pasquale Di Pietro ; Salvatore Renna ; Rossella Rossi ; Bianca Domenichini ; Stefania Gamba ; Francesco Trovato ; Pier-Angelo Tovo ; Manuela Bianciotto ; Carmelina Calitri ; Clara Gabiano ; Irene Raffaldi ; Antonio Urbino ; Liviana Da Dalt ; Valentina Favero ; Laura Giordano ; Maura Baraldi ; Federica Bertuola ; Eleonora Lorenzon ; Francesca Parata ; Giorgio Perilongo ; Silvia Vendramin ; Monica Frassineti ; Anna Maria Calvani ; Elena Chiappini ; Maurizio De Martino ; Claudia Fancelli ; Francesco Mannelli ; Rachele Mazzantini ; Sara Sollai ; Elisabetta Venturini ; Nicola Pirozzi ; Umberto Raucci ; Antonino Reale ; Rossella Rossi ; Nadia Mores ; Giulia Bersani ; Alessia De Nisco ; Antonio Chiaretti ; Riccardo Riccardi ; Costantino Romagnoli ; Vincenzo Tipo ; Michele Dinardo ; Teresa Pisapia ; Annalisa Capuano ; Elisabetta Parretta ; Concita Rafaniello ; Fortunata Fucà ; Eleonora Di RosaSource :
- Archives of Disease in Childhood [ 0003-9888 ] ; 2013-03.
Abstract
Objective To evaluate the risk of upper gastrointestinal complications (UGIC) associated with drug use in the paediatric population. Methods This study is part of a large Italian prospective multicentre study. The study population included children hospitalised for acute conditions through the emergency departments of eight clinical centres. Patients admitted for UGIC (defined as endoscopically confirmed gastroduodenal lesions or clinically defined haematemesis or melena) comprised the case series; children hospitalised for neurological disorders formed the control group. Information on drug and vaccine exposure was collected through parental interview during the children's hospitalisation. Logistic regression was used to estimate ORs for the occurrence of UGIC associated with drug use adjusted for age, clinical centre and concomitant use of any drug. Results 486 children hospitalised for UGIC and 1930 for neurological disorders were enrolled between November 1999 and November 2010. Drug use was higher in cases than in controls (73% vs 54%; p<0.001). UGICs were associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) (adjusted OR 2.9, 95% CI 2.1 to 4.0), oral steroids (adjusted OR 2.9, 95% CI 1.7 to 4.8) and antibiotics (adjusted OR 2.3, 95% CI 1.8 to 3.1). The duration of use of these drug categories was short (range 1–8 days). Paracetamol showed a lower risk (adjusted OR 2.0, 95% CI 1.5 to 2.6) compared to ibuprofen (adjusted OR 3.7, 95% CI 2.3 to 5.9), although with partially overlapping CIs. Conclusions NSAIDs, oral steroids and antibiotics, even when administered for a short period, were associated with an increased risk of UGIC.
Url:
DOI: 10.1136/archdischild-2012-302100
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<sourceDesc><biblStruct><analytic><title level="a">Drug use and upper gastrointestinal complications in children: a case–control study</title>
<author><name sortKey="Bianciotto, Manuela" sort="Bianciotto, Manuela" uniqKey="Bianciotto M" first="Manuela" last="Bianciotto">Manuela Bianciotto</name>
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<author><name sortKey="Gabiano, Clara" sort="Gabiano, Clara" uniqKey="Gabiano C" first="Clara" last="Gabiano">Clara Gabiano</name>
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<author><name sortKey="Traversa, Giuseppe" sort="Traversa, Giuseppe" uniqKey="Traversa G" first="Giuseppe" last="Traversa">Giuseppe Traversa</name>
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<author><name sortKey="Menniti Ippolito, Francesca" sort="Menniti Ippolito, Francesca" uniqKey="Menniti Ippolito F" first="Francesca" last="Menniti-Ippolito">Francesca Menniti-Ippolito</name>
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<author wicri:is="80%"><name sortKey="Menniti Ippolito, Francesca" sort="Menniti Ippolito, Francesca" uniqKey="Menniti Ippolito F" first="Francesca" last="Menniti-Ippolito">Francesca Menniti-Ippolito</name>
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<author wicri:is="80%"><name sortKey="Da Cas, Roberto" sort="Da Cas, Roberto" uniqKey="Da Cas R" first="Roberto" last="Da Cas">Roberto Da Cas</name>
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<author wicri:is="80%"><name sortKey="Sagliocca, Luciano" sort="Sagliocca, Luciano" uniqKey="Sagliocca L" first="Luciano" last="Sagliocca">Luciano Sagliocca</name>
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<author wicri:is="80%"><name sortKey="Traversa, Giuseppe" sort="Traversa, Giuseppe" uniqKey="Traversa G" first="Giuseppe" last="Traversa">Giuseppe Traversa</name>
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<series><title level="j">Archives of Disease in Childhood</title>
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<front><div type="abstract">Objective To evaluate the risk of upper gastrointestinal complications (UGIC) associated with drug use in the paediatric population. Methods This study is part of a large Italian prospective multicentre study. The study population included children hospitalised for acute conditions through the emergency departments of eight clinical centres. Patients admitted for UGIC (defined as endoscopically confirmed gastroduodenal lesions or clinically defined haematemesis or melena) comprised the case series; children hospitalised for neurological disorders formed the control group. Information on drug and vaccine exposure was collected through parental interview during the children's hospitalisation. Logistic regression was used to estimate ORs for the occurrence of UGIC associated with drug use adjusted for age, clinical centre and concomitant use of any drug. Results 486 children hospitalised for UGIC and 1930 for neurological disorders were enrolled between November 1999 and November 2010. Drug use was higher in cases than in controls (73% vs 54%; p<0.001). UGICs were associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) (adjusted OR 2.9, 95% CI 2.1 to 4.0), oral steroids (adjusted OR 2.9, 95% CI 1.7 to 4.8) and antibiotics (adjusted OR 2.3, 95% CI 1.8 to 3.1). The duration of use of these drug categories was short (range 1–8 days). Paracetamol showed a lower risk (adjusted OR 2.0, 95% CI 1.5 to 2.6) compared to ibuprofen (adjusted OR 3.7, 95% CI 2.3 to 5.9), although with partially overlapping CIs. Conclusions NSAIDs, oral steroids and antibiotics, even when administered for a short period, were associated with an increased risk of UGIC.</div>
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<author><json:item><name>Manuela Bianciotto</name>
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<abstract>Objective To evaluate the risk of upper gastrointestinal complications (UGIC) associated with drug use in the paediatric population. Methods This study is part of a large Italian prospective multicentre study. The study population included children hospitalised for acute conditions through the emergency departments of eight clinical centres. Patients admitted for UGIC (defined as endoscopically confirmed gastroduodenal lesions or clinically defined haematemesis or melena) comprised the case series; children hospitalised for neurological disorders formed the control group. Information on drug and vaccine exposure was collected through parental interview during the children's hospitalisation. Logistic regression was used to estimate ORs for the occurrence of UGIC associated with drug use adjusted for age, clinical centre and concomitant use of any drug. Results 486 children hospitalised for UGIC and 1930 for neurological disorders were enrolled between November 1999 and November 2010. Drug use was higher in cases than in controls (73% vs 54%; p>0.001). UGICs were associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) (adjusted OR 2.9, 95% CI 2.1 to 4.0), oral steroids (adjusted OR 2.9, 95% CI 1.7 to 4.8) and antibiotics (adjusted OR 2.3, 95% CI 1.8 to 3.1). The duration of use of these drug categories was short (range 1–8 days). Paracetamol showed a lower risk (adjusted OR 2.0, 95% CI 1.5 to 2.6) compared to ibuprofen (adjusted OR 3.7, 95% CI 2.3 to 5.9), although with partially overlapping CIs. Conclusions NSAIDs, oral steroids and antibiotics, even when administered for a short period, were associated with an increased risk of UGIC.</abstract>
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<affiliation>Regina Margherita Children's Hospital, Turin, Italy</affiliation>
</author>
<author xml:id="author-6"><persName><forename type="first">Pier-Angelo</forename>
<surname>Tovo</surname>
</persName>
<affiliation>Regina Margherita Children's Hospital, Turin, Italy</affiliation>
</author>
<author xml:id="author-7"><persName><forename type="first">Sara</forename>
<surname>Sollai</surname>
</persName>
<affiliation>Anna Meyer Children's University Hospital, Florence, Italy</affiliation>
</author>
<author xml:id="author-8"><persName><forename type="first">Maurizio</forename>
<surname>de Martino</surname>
</persName>
<affiliation>Anna Meyer Children's University Hospital, Florence, Italy</affiliation>
</author>
<author xml:id="author-9"><persName><forename type="first">Francesco</forename>
<surname>Mannelli</surname>
</persName>
<affiliation>Anna Meyer Children's University Hospital, Florence, Italy</affiliation>
</author>
<author xml:id="author-10"><persName><forename type="first">Vincenzo</forename>
<surname>Tipo</surname>
</persName>
<affiliation>Santobono Paediatric Hospital, Naples, Italy</affiliation>
</author>
<author xml:id="author-11"><persName><forename type="first">Roberto</forename>
<surname>Da Cas</surname>
</persName>
<affiliation>National Centre for Epidemiology, Italian National Institute of Health, Rome, Italy</affiliation>
</author>
<author xml:id="author-12"><persName><forename type="first">Giuseppe</forename>
<surname>Traversa</surname>
</persName>
<affiliation>National Centre for Epidemiology, Italian National Institute of Health, Rome, Italy</affiliation>
</author>
<author xml:id="author-13"><persName><forename type="first">Francesca</forename>
<surname>Menniti-Ippolito</surname>
</persName>
<affiliation>National Centre for Epidemiology, Italian National Institute of Health, Rome, Italy</affiliation>
</author>
<author xml:id="author-14"><persName><forename type="first">Francesca</forename>
<surname>Menniti-Ippolito</surname>
</persName>
</author>
<author xml:id="author-15"><persName><forename type="first">Roberto</forename>
<surname>Da Cas</surname>
</persName>
</author>
<author xml:id="author-16"><persName><forename type="first">Luciano</forename>
<surname>Sagliocca</surname>
</persName>
</author>
<author xml:id="author-17"><persName><forename type="first">Giuseppe</forename>
<surname>Traversa</surname>
</persName>
</author>
<author xml:id="author-18"><persName><forename type="first">Fernanda</forename>
<surname>Ferrazin</surname>
</persName>
</author>
<author xml:id="author-19"><persName><forename type="first">Carmela</forename>
<surname>Santuccio</surname>
</persName>
</author>
<author xml:id="author-20"><persName><forename type="first">Loriana</forename>
<surname>Tartaglia</surname>
</persName>
</author>
<author xml:id="author-21"><persName><forename type="first">Francesco</forename>
<surname>Trotta</surname>
</persName>
</author>
<author xml:id="author-22"><persName><forename type="first">Pasquale</forename>
<surname>Di Pietro</surname>
</persName>
</author>
<author xml:id="author-23"><persName><forename type="first">Salvatore</forename>
<surname>Renna</surname>
</persName>
</author>
<author xml:id="author-24"><persName><forename type="first">Rossella</forename>
<surname>Rossi</surname>
</persName>
</author>
<author xml:id="author-25"><persName><forename type="first">Bianca</forename>
<surname>Domenichini</surname>
</persName>
</author>
<author xml:id="author-26"><persName><forename type="first">Stefania</forename>
<surname>Gamba</surname>
</persName>
</author>
<author xml:id="author-27"><persName><forename type="first">Francesco</forename>
<surname>Trovato</surname>
</persName>
</author>
<author xml:id="author-28"><persName><forename type="first">Pier-Angelo</forename>
<surname>Tovo</surname>
</persName>
</author>
<author xml:id="author-29"><persName><forename type="first">Manuela</forename>
<surname>Bianciotto</surname>
</persName>
</author>
<author xml:id="author-30"><persName><forename type="first">Carmelina</forename>
<surname>Calitri</surname>
</persName>
</author>
<author xml:id="author-31"><persName><forename type="first">Clara</forename>
<surname>Gabiano</surname>
</persName>
</author>
<author xml:id="author-32"><persName><forename type="first">Irene</forename>
<surname>Raffaldi</surname>
</persName>
</author>
<author xml:id="author-33"><persName><forename type="first">Antonio</forename>
<surname>Urbino</surname>
</persName>
</author>
<author xml:id="author-34"><persName><forename type="first">Liviana</forename>
<surname>Da Dalt</surname>
</persName>
</author>
<author xml:id="author-35"><persName><forename type="first">Valentina</forename>
<surname>Favero</surname>
</persName>
</author>
<author xml:id="author-36"><persName><forename type="first">Laura</forename>
<surname>Giordano</surname>
</persName>
</author>
<author xml:id="author-37"><persName><forename type="first">Maura</forename>
<surname>Baraldi</surname>
</persName>
</author>
<author xml:id="author-38"><persName><forename type="first">Federica</forename>
<surname>Bertuola</surname>
</persName>
</author>
<author xml:id="author-39"><persName><forename type="first">Eleonora</forename>
<surname>Lorenzon</surname>
</persName>
</author>
<author xml:id="author-40"><persName><forename type="first">Francesca</forename>
<surname>Parata</surname>
</persName>
</author>
<author xml:id="author-41"><persName><forename type="first">Giorgio</forename>
<surname>Perilongo</surname>
</persName>
</author>
<author xml:id="author-42"><persName><forename type="first">Silvia</forename>
<surname>Vendramin</surname>
</persName>
</author>
<author xml:id="author-43"><persName><forename type="first">Monica</forename>
<surname>Frassineti</surname>
</persName>
</author>
<author xml:id="author-44"><persName><forename type="first">Anna Maria</forename>
<surname>Calvani</surname>
</persName>
</author>
<author xml:id="author-45"><persName><forename type="first">Elena</forename>
<surname>Chiappini</surname>
</persName>
</author>
<author xml:id="author-46"><persName><forename type="first">Maurizio</forename>
<surname>De Martino</surname>
</persName>
</author>
<author xml:id="author-47"><persName><forename type="first">Claudia</forename>
<surname>Fancelli</surname>
</persName>
</author>
<author xml:id="author-48"><persName><forename type="first">Francesco</forename>
<surname>Mannelli</surname>
</persName>
</author>
<author xml:id="author-49"><persName><forename type="first">Rachele</forename>
<surname>Mazzantini</surname>
</persName>
</author>
<author xml:id="author-50"><persName><forename type="first">Sara</forename>
<surname>Sollai</surname>
</persName>
</author>
<author xml:id="author-51"><persName><forename type="first">Elisabetta</forename>
<surname>Venturini</surname>
</persName>
</author>
<author xml:id="author-52"><persName><forename type="first">Nicola</forename>
<surname>Pirozzi</surname>
</persName>
</author>
<author xml:id="author-53"><persName><forename type="first">Umberto</forename>
<surname>Raucci</surname>
</persName>
</author>
<author xml:id="author-54"><persName><forename type="first">Antonino</forename>
<surname>Reale</surname>
</persName>
</author>
<author xml:id="author-55"><persName><forename type="first">Rossella</forename>
<surname>Rossi</surname>
</persName>
</author>
<author xml:id="author-56"><persName><forename type="first">Nadia</forename>
<surname>Mores</surname>
</persName>
</author>
<author xml:id="author-57"><persName><forename type="first">Giulia</forename>
<surname>Bersani</surname>
</persName>
</author>
<author xml:id="author-58"><persName><forename type="first">Alessia</forename>
<surname>De Nisco</surname>
</persName>
</author>
<author xml:id="author-59"><persName><forename type="first">Antonio</forename>
<surname>Chiaretti</surname>
</persName>
</author>
<author xml:id="author-60"><persName><forename type="first">Riccardo</forename>
<surname>Riccardi</surname>
</persName>
</author>
<author xml:id="author-61"><persName><forename type="first">Costantino</forename>
<surname>Romagnoli</surname>
</persName>
</author>
<author xml:id="author-62"><persName><forename type="first">Vincenzo</forename>
<surname>Tipo</surname>
</persName>
</author>
<author xml:id="author-63"><persName><forename type="first">Michele</forename>
<surname>Dinardo</surname>
</persName>
</author>
<author xml:id="author-64"><persName><forename type="first">Teresa</forename>
<surname>Pisapia</surname>
</persName>
</author>
<author xml:id="author-65"><persName><forename type="first">Annalisa</forename>
<surname>Capuano</surname>
</persName>
</author>
<author xml:id="author-66"><persName><forename type="first">Elisabetta</forename>
<surname>Parretta</surname>
</persName>
</author>
<author xml:id="author-67"><persName><forename type="first">Concita</forename>
<surname>Rafaniello</surname>
</persName>
</author>
<author xml:id="author-68"><persName><forename type="first">Fortunata</forename>
<surname>Fucà</surname>
</persName>
</author>
<author xml:id="author-69"><persName><forename type="first">Eleonora</forename>
<surname>Di Rosa</surname>
</persName>
</author>
</analytic>
<monogr><title level="j">Archives of Disease in Childhood</title>
<title level="j" type="abbrev">Arch Dis Child</title>
<idno type="pISSN">0003-9888</idno>
<idno type="eISSN">1468-2044</idno>
<imprint><publisher>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</publisher>
<date type="published" when="2013-03"></date>
<biblScope unit="volume">98</biblScope>
<biblScope unit="issue">3</biblScope>
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<idno type="DOI">10.1136/archdischild-2012-302100</idno>
<idno type="href">archdischild-98-218.pdf</idno>
<idno type="ArticleID">archdischild-2012-302100</idno>
<idno type="PMID">23264432</idno>
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<abstract><p>Objective To evaluate the risk of upper gastrointestinal complications (UGIC) associated with drug use in the paediatric population. Methods This study is part of a large Italian prospective multicentre study. The study population included children hospitalised for acute conditions through the emergency departments of eight clinical centres. Patients admitted for UGIC (defined as endoscopically confirmed gastroduodenal lesions or clinically defined haematemesis or melena) comprised the case series; children hospitalised for neurological disorders formed the control group. Information on drug and vaccine exposure was collected through parental interview during the children's hospitalisation. Logistic regression was used to estimate ORs for the occurrence of UGIC associated with drug use adjusted for age, clinical centre and concomitant use of any drug. Results 486 children hospitalised for UGIC and 1930 for neurological disorders were enrolled between November 1999 and November 2010. Drug use was higher in cases than in controls (73% vs 54%; p<0.001). UGICs were associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) (adjusted OR 2.9, 95% CI 2.1 to 4.0), oral steroids (adjusted OR 2.9, 95% CI 1.7 to 4.8) and antibiotics (adjusted OR 2.3, 95% CI 1.8 to 3.1). The duration of use of these drug categories was short (range 1–8 days). Paracetamol showed a lower risk (adjusted OR 2.0, 95% CI 1.5 to 2.6) compared to ibuprofen (adjusted OR 3.7, 95% CI 2.3 to 5.9), although with partially overlapping CIs. Conclusions NSAIDs, oral steroids and antibiotics, even when administered for a short period, were associated with an increased risk of UGIC.</p>
</abstract>
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<textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head>
<item><term>ADC Paediatric and Perinatal Drug Therapy</term>
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<textClass><keywords scheme="keyword"><list><head>keywords</head>
<item><term>gastrointestinal complications</term>
</item>
<item><term>drug use</term>
</item>
<item><term>adverse events</term>
</item>
<item><term>case-control study</term>
</item>
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<journal-id journal-id-type="nlm-ta">Arch Dis Child</journal-id>
<journal-id journal-id-type="publisher-id">adc</journal-id>
<journal-title>Archives of Disease in Childhood</journal-title>
<abbrev-journal-title abbrev-type="publisher">Arch Dis Child</abbrev-journal-title>
<abbrev-journal-title>Arch Dis Child</abbrev-journal-title>
<issn pub-type="ppub">0003-9888</issn>
<issn pub-type="epub">1468-2044</issn>
<publisher><publisher-name>BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health</publisher-name>
</publisher>
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<article-meta><article-id pub-id-type="publisher-id">archdischild-2012-302100</article-id>
<article-id pub-id-type="doi">10.1136/archdischild-2012-302100</article-id>
<article-id pub-id-type="other">archdischild;98/3/218</article-id>
<article-id pub-id-type="other">archdischild;archdischild-2012-302100</article-id>
<article-id pub-id-type="pmid">23264432</article-id>
<article-id pub-id-type="other">218</article-id>
<article-id pub-id-type="other">archdischild-2012-302100</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Drug therapy</subject>
</subj-group>
<subj-group subj-group-type="hwp-journal-coll"><subject>Open access</subject>
</subj-group>
<subj-group subj-group-type="hwp-journal-coll"><subject>ADC Paediatric and Perinatal Drug Therapy</subject>
</subj-group>
<series-title>Original article</series-title>
</article-categories>
<title-group><article-title>Drug use and upper gastrointestinal complications in children: a case–control study</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Bianciotto</surname>
<given-names>Manuela</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chiappini</surname>
<given-names>Elena</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Raffaldi</surname>
<given-names>Irene</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gabiano</surname>
<given-names>Clara</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tovo</surname>
<given-names>Pier-Angelo</given-names>
</name>
<xref ref-type="aff" rid="af1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sollai</surname>
<given-names>Sara</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>de Martino</surname>
<given-names>Maurizio</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mannelli</surname>
<given-names>Francesco</given-names>
</name>
<xref ref-type="aff" rid="af2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tipo</surname>
<given-names>Vincenzo</given-names>
</name>
<xref ref-type="aff" rid="af3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Da Cas</surname>
<given-names>Roberto</given-names>
</name>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Traversa</surname>
<given-names>Giuseppe</given-names>
</name>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Menniti-Ippolito</surname>
<given-names>Francesca</given-names>
</name>
<xref ref-type="aff" rid="af4">4</xref>
</contrib>
<contrib contrib-type="author"><collab>and the Italian Multicenter Study Group for Drug and Vaccine Safety in Children</collab>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Menniti-Ippolito</surname>
<given-names>Francesca</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Da Cas</surname>
<given-names>Roberto</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Sagliocca</surname>
<given-names>Luciano</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Traversa</surname>
<given-names>Giuseppe</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Ferrazin</surname>
<given-names>Fernanda</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Santuccio</surname>
<given-names>Carmela</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Tartaglia</surname>
<given-names>Loriana</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Trotta</surname>
<given-names>Francesco</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Di Pietro</surname>
<given-names>Pasquale</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Renna</surname>
<given-names>Salvatore</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Rossi</surname>
<given-names>Rossella</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Domenichini</surname>
<given-names>Bianca</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Gamba</surname>
<given-names>Stefania</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Trovato</surname>
<given-names>Francesco</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Tovo</surname>
<given-names>Pier-Angelo</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Bianciotto</surname>
<given-names>Manuela</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Calitri</surname>
<given-names>Carmelina</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Gabiano</surname>
<given-names>Clara</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Raffaldi</surname>
<given-names>Irene</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Urbino</surname>
<given-names>Antonio</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Da Dalt</surname>
<given-names>Liviana</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Favero</surname>
<given-names>Valentina</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Giordano</surname>
<given-names>Laura</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Baraldi</surname>
<given-names>Maura</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Bertuola</surname>
<given-names>Federica</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Lorenzon</surname>
<given-names>Eleonora</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Parata</surname>
<given-names>Francesca</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Perilongo</surname>
<given-names>Giorgio</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Vendramin</surname>
<given-names>Silvia</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Frassineti</surname>
<given-names>Monica</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Calvani</surname>
<given-names>Anna Maria</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Chiappini</surname>
<given-names>Elena</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>De Martino</surname>
<given-names>Maurizio</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Fancelli</surname>
<given-names>Claudia</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Mannelli</surname>
<given-names>Francesco</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Mazzantini</surname>
<given-names>Rachele</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Sollai</surname>
<given-names>Sara</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Venturini</surname>
<given-names>Elisabetta</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Pirozzi</surname>
<given-names>Nicola</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Raucci</surname>
<given-names>Umberto</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Reale</surname>
<given-names>Antonino</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Rossi</surname>
<given-names>Rossella</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Mores</surname>
<given-names>Nadia</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Bersani</surname>
<given-names>Giulia</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>De Nisco</surname>
<given-names>Alessia</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Chiaretti</surname>
<given-names>Antonio</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Riccardi</surname>
<given-names>Riccardo</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Romagnoli</surname>
<given-names>Costantino</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Tipo</surname>
<given-names>Vincenzo</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Dinardo</surname>
<given-names>Michele</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Pisapia</surname>
<given-names>Teresa</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Capuano</surname>
<given-names>Annalisa</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Parretta</surname>
<given-names>Elisabetta</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Rafaniello</surname>
<given-names>Concita</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Fucà</surname>
<given-names>Fortunata</given-names>
</name>
</contrib>
<contrib contrib-type="author non-byline"><name><surname>Di Rosa</surname>
<given-names>Eleonora</given-names>
</name>
</contrib>
</contrib-group>
<aff id="af1"><label>1</label>
<institution>Regina Margherita Children's Hospital</institution>
, <addr-line>Turin</addr-line>
, <country>Italy</country>
</aff>
<aff id="af2"><label>2</label>
<institution>Anna Meyer Children's University Hospital</institution>
, <addr-line>Florence</addr-line>
, <country>Italy</country>
</aff>
<aff id="af3"><label>3</label>
<institution>Santobono Paediatric Hospital</institution>
, <addr-line>Naples</addr-line>
, <country>Italy</country>
</aff>
<aff id="af4"><label>4</label>
<addr-line>National Centre for Epidemiology</addr-line>
, <institution>Italian National Institute of Health</institution>
, <addr-line>Rome</addr-line>
, <country>Italy</country>
</aff>
<author-notes><corresp><label>Correspondence to</label>
Dr Francesca Menniti-Ippolito, National Centre for Epidemiology, National Institute of Health, Viale Regina Elena 299, Rome 00161, Italy; <email>francesca.menniti@iss.it</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>3</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="epub-original"><day>21</day>
<month>12</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>21</day>
<month>12</month>
<year>2012</year>
</pub-date>
<volume>98</volume>
<volume-id pub-id-type="other">98</volume-id>
<volume-id pub-id-type="other">98</volume-id>
<issue>3</issue>
<issue-id pub-id-type="other">archdischild;98/3</issue-id>
<issue-id pub-id-type="other">3</issue-id>
<issue-id pub-id-type="other">98/3</issue-id>
<fpage>218</fpage>
<history><date date-type="received"><day>26</day>
<month>3</month>
<year>2012</year>
</date>
<date date-type="rev-recd"><day>25</day>
<month>10</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>26</day>
<month>10</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</copyright-statement>
<copyright-year>2013</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>
and <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/legalcode">http://creativecommons.org/licenses/by-nc/3.0/legalcode</ext-link>
</p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:role="full-text" xlink:href="archdischild-98-218.pdf"></self-uri>
<abstract><sec><title>Objective</title>
<p>To evaluate the risk of upper gastrointestinal complications (UGIC) associated with drug use in the paediatric population.</p>
</sec>
<sec><title>Methods</title>
<p>This study is part of a large Italian prospective multicentre study. The study population included children hospitalised for acute conditions through the emergency departments of eight clinical centres. Patients admitted for UGIC (defined as endoscopically confirmed gastroduodenal lesions or clinically defined haematemesis or melena) comprised the case series; children hospitalised for neurological disorders formed the control group. Information on drug and vaccine exposure was collected through parental interview during the children's hospitalisation. Logistic regression was used to estimate ORs for the occurrence of UGIC associated with drug use adjusted for age, clinical centre and concomitant use of any drug.</p>
</sec>
<sec><title>Results</title>
<p>486 children hospitalised for UGIC and 1930 for neurological disorders were enrolled between November 1999 and November 2010. Drug use was higher in cases than in controls (73% vs 54%; p<0.001). UGICs were associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) (adjusted OR 2.9, 95% CI 2.1 to 4.0), oral steroids (adjusted OR 2.9, 95% CI 1.7 to 4.8) and antibiotics (adjusted OR 2.3, 95% CI 1.8 to 3.1). The duration of use of these drug categories was short (range 1–8 days). Paracetamol showed a lower risk (adjusted OR 2.0, 95% CI 1.5 to 2.6) compared to ibuprofen (adjusted OR 3.7, 95% CI 2.3 to 5.9), although with partially overlapping CIs.</p>
</sec>
<sec><title>Conclusions</title>
<p>NSAIDs, oral steroids and antibiotics, even when administered for a short period, were associated with an increased risk of UGIC.</p>
</sec>
</abstract>
<kwd-group><kwd>gastrointestinal complications</kwd>
<kwd>drug use</kwd>
<kwd>adverse events</kwd>
<kwd>case-control study</kwd>
</kwd-group>
</article-meta>
</front>
</article>
</istex:document>
</istex:metadataXml>
<mods version="3.6"><titleInfo><title>Drug use and upper gastrointestinal complications in children: a case–control study</title>
<partName>Original article</partName>
</titleInfo>
<titleInfo type="alternative" contentType="CDATA"><title>Drug use and upper gastrointestinal complications in children: a case–control study</title>
<partName>Original article</partName>
</titleInfo>
<name type="corporate"><namePart>and the Italian Multicenter Study Group for Drug and Vaccine Safety in Children</namePart>
</name>
<name type="personal"><namePart type="given">Manuela</namePart>
<namePart type="family">Bianciotto</namePart>
<affiliation>Regina Margherita Children's Hospital, Turin, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Elena</namePart>
<namePart type="family">Chiappini</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Irene</namePart>
<namePart type="family">Raffaldi</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Clara</namePart>
<namePart type="family">Gabiano</namePart>
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<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Pier-Angelo</namePart>
<namePart type="family">Tovo</namePart>
<affiliation>Regina Margherita Children's Hospital, Turin, Italy</affiliation>
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</role>
</name>
<name type="personal"><namePart type="given">Sara</namePart>
<namePart type="family">Sollai</namePart>
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<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Maurizio</namePart>
<namePart type="family">de Martino</namePart>
<affiliation>Anna Meyer Children's University Hospital, Florence, Italy</affiliation>
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</role>
</name>
<name type="personal"><namePart type="given">Francesco</namePart>
<namePart type="family">Mannelli</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Vincenzo</namePart>
<namePart type="family">Tipo</namePart>
<affiliation>Santobono Paediatric Hospital, Naples, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Roberto</namePart>
<namePart type="family">Da Cas</namePart>
<affiliation>National Centre for Epidemiology, Italian National Institute of Health, Rome, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Giuseppe</namePart>
<namePart type="family">Traversa</namePart>
<affiliation>National Centre for Epidemiology, Italian National Institute of Health, Rome, Italy</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Francesca</namePart>
<namePart type="family">Menniti-Ippolito</namePart>
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<name type="personal"><namePart type="given">Francesca</namePart>
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</name>
<name type="personal"><namePart type="given">Roberto</namePart>
<namePart type="family">Da Cas</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Luciano</namePart>
<namePart type="family">Sagliocca</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Giuseppe</namePart>
<namePart type="family">Traversa</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Fernanda</namePart>
<namePart type="family">Ferrazin</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Carmela</namePart>
<namePart type="family">Santuccio</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Loriana</namePart>
<namePart type="family">Tartaglia</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Francesco</namePart>
<namePart type="family">Trotta</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Pasquale</namePart>
<namePart type="family">Di Pietro</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Salvatore</namePart>
<namePart type="family">Renna</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Rossella</namePart>
<namePart type="family">Rossi</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Bianca</namePart>
<namePart type="family">Domenichini</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Stefania</namePart>
<namePart type="family">Gamba</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Francesco</namePart>
<namePart type="family">Trovato</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Pier-Angelo</namePart>
<namePart type="family">Tovo</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Manuela</namePart>
<namePart type="family">Bianciotto</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Carmelina</namePart>
<namePart type="family">Calitri</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Clara</namePart>
<namePart type="family">Gabiano</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Irene</namePart>
<namePart type="family">Raffaldi</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Antonio</namePart>
<namePart type="family">Urbino</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Liviana</namePart>
<namePart type="family">Da Dalt</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Valentina</namePart>
<namePart type="family">Favero</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Laura</namePart>
<namePart type="family">Giordano</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Maura</namePart>
<namePart type="family">Baraldi</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Federica</namePart>
<namePart type="family">Bertuola</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Eleonora</namePart>
<namePart type="family">Lorenzon</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Francesca</namePart>
<namePart type="family">Parata</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Giorgio</namePart>
<namePart type="family">Perilongo</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Silvia</namePart>
<namePart type="family">Vendramin</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Monica</namePart>
<namePart type="family">Frassineti</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Anna Maria</namePart>
<namePart type="family">Calvani</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Elena</namePart>
<namePart type="family">Chiappini</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Maurizio</namePart>
<namePart type="family">De Martino</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Claudia</namePart>
<namePart type="family">Fancelli</namePart>
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</name>
<name type="personal"><namePart type="given">Francesco</namePart>
<namePart type="family">Mannelli</namePart>
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<name type="personal"><namePart type="given">Rachele</namePart>
<namePart type="family">Mazzantini</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Sara</namePart>
<namePart type="family">Sollai</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Elisabetta</namePart>
<namePart type="family">Venturini</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Nicola</namePart>
<namePart type="family">Pirozzi</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Umberto</namePart>
<namePart type="family">Raucci</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Antonino</namePart>
<namePart type="family">Reale</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Rossella</namePart>
<namePart type="family">Rossi</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Nadia</namePart>
<namePart type="family">Mores</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Giulia</namePart>
<namePart type="family">Bersani</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Alessia</namePart>
<namePart type="family">De Nisco</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Antonio</namePart>
<namePart type="family">Chiaretti</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Riccardo</namePart>
<namePart type="family">Riccardi</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Costantino</namePart>
<namePart type="family">Romagnoli</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Vincenzo</namePart>
<namePart type="family">Tipo</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Michele</namePart>
<namePart type="family">Dinardo</namePart>
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</role>
</name>
<name type="personal"><namePart type="given">Teresa</namePart>
<namePart type="family">Pisapia</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Annalisa</namePart>
<namePart type="family">Capuano</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Elisabetta</namePart>
<namePart type="family">Parretta</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Concita</namePart>
<namePart type="family">Rafaniello</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Fortunata</namePart>
<namePart type="family">Fucà</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Eleonora</namePart>
<namePart type="family">Di Rosa</namePart>
<role><roleTerm type="text">author non-byline</roleTerm>
</role>
</name>
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<subject><genre>hwp-journal-coll</genre>
<topic>ADC Paediatric and Perinatal Drug Therapy</topic>
</subject>
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<abstract>Objective To evaluate the risk of upper gastrointestinal complications (UGIC) associated with drug use in the paediatric population. Methods This study is part of a large Italian prospective multicentre study. The study population included children hospitalised for acute conditions through the emergency departments of eight clinical centres. Patients admitted for UGIC (defined as endoscopically confirmed gastroduodenal lesions or clinically defined haematemesis or melena) comprised the case series; children hospitalised for neurological disorders formed the control group. Information on drug and vaccine exposure was collected through parental interview during the children's hospitalisation. Logistic regression was used to estimate ORs for the occurrence of UGIC associated with drug use adjusted for age, clinical centre and concomitant use of any drug. Results 486 children hospitalised for UGIC and 1930 for neurological disorders were enrolled between November 1999 and November 2010. Drug use was higher in cases than in controls (73% vs 54%; p<0.001). UGICs were associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs) (adjusted OR 2.9, 95% CI 2.1 to 4.0), oral steroids (adjusted OR 2.9, 95% CI 1.7 to 4.8) and antibiotics (adjusted OR 2.3, 95% CI 1.8 to 3.1). The duration of use of these drug categories was short (range 1–8 days). Paracetamol showed a lower risk (adjusted OR 2.0, 95% CI 1.5 to 2.6) compared to ibuprofen (adjusted OR 3.7, 95% CI 2.3 to 5.9), although with partially overlapping CIs. Conclusions NSAIDs, oral steroids and antibiotics, even when administered for a short period, were associated with an increased risk of UGIC.</abstract>
<subject><genre>keywords</genre>
<topic>gastrointestinal complications</topic>
<topic>drug use</topic>
<topic>adverse events</topic>
<topic>case-control study</topic>
</subject>
<relatedItem type="host"><titleInfo><title>Archives of Disease in Childhood</title>
</titleInfo>
<titleInfo type="abbreviated"><title>Arch Dis Child</title>
</titleInfo>
<genre type="journal">journal</genre>
<identifier type="ISSN">0003-9888</identifier>
<identifier type="eISSN">1468-2044</identifier>
<identifier type="PublisherID">adc</identifier>
<identifier type="PublisherID-hwp">archdischild</identifier>
<identifier type="PublisherID-nlm-ta">Arch Dis Child</identifier>
<part><date>2013</date>
<detail type="volume"><caption>vol.</caption>
<number>98</number>
</detail>
<detail type="issue"><caption>no.</caption>
<number>3</number>
</detail>
<extent unit="pages"><start>218</start>
</extent>
</part>
</relatedItem>
<identifier type="istex">72B3DB96F35726A7D6EA32A4DBC643D22666C33B</identifier>
<identifier type="DOI">10.1136/archdischild-2012-302100</identifier>
<identifier type="href">archdischild-98-218.pdf</identifier>
<identifier type="ArticleID">archdischild-2012-302100</identifier>
<identifier type="PMID">23264432</identifier>
<identifier type="local">archdischild;98/3/218</identifier>
<accessCondition type="use and reproduction" contentType="open-access">This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode</accessCondition>
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