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The NSAIDs are used increasingly in multimodal management of pain and fever.[1] Ketoprofen has been in use in Europe since 1974[2] and in the US since the 1980s. Ketoprofen is a potent, classical NSAID of the arylpropionic acid class.[3] Classical NSAIDs inhibit prostaglandin synthesis by inhibiting the cyclo-oxygenase (COX) enzyme.[3] Ketoprofen exhibits analgesic, antipyretic, and anti-inflammatory properties through non-specific COX-1 and COX-2 inhibition,[3] thought to occur mainly in peripheral sites, although recent studies indicate that ketoprofen also appears to have central effects.[4] Ketoprofen is a chiral molecule and only the S-enantiomer has beneficial biological activity.[5]
Conditions causing elevated body temperature and acute pain (e.g. injury, illness, or medical procedures) are common in children, with NSAIDs frequently being used in children for the symptomatic treatment of fever and for pain management.[3,6] Acute pediatric pain causes increased anxiety, avoidance behavior, somatic symptoms, and distress in both the child and caregiver, and could cause long-lasting untoward effects on both the growing body and the mind of the child.[6] Pain in infants, children, and adolescents is often poorly assessed and managed.[6] One of the main reasons for this is a lack of knowledge of the dosages and formulations of analgesics that are appropriate for this patient population.[6] Other contributing factors include inappropriate recognition and evaluation of pain in children, and fear of adverse effects of the analgesics.[6] Fever in children is a source of great concern to caregivers, and the primary method of body temperature control is the appropriate use of antipyretic drugs.[7]
Currently approved indications for ketoprofen in adults include pain, fever, and certain inflammatory and musculoskeletal conditions.[8] Ketoprofen is available in intravenous, intramuscular, oral (tablet and syrup), rectal, and topical formulations. In children, ketoprofen has been investigated in postsurgical pain, predominantly in an intravenous formulation, although the oral, intramuscular, and rectal formulations have also been investigated. The oral tablet and syrup formulations have been assessed for use in fever and/or pain, and in inflammatory conditions. In pediatric patients, ketoprofen is used for symptomatic relief of fever and management of pain in infants and children aged 6 months to 11 years (up to 35 kg). Ketoprofen syrup has been approved for use in children in various countries. In addition, ketoprofen is currently approved worldwide for use in...