Que. The role of aspirin in the management of febrile illness especially in children has been controversial. Discuss why non steroidal anti- inflammatory drugs (NSAIDS) may be more effective in the management of bacterial infections. (Leanne Berkahn)
Ans. Febrile illness is a kind of illness that occurs with impetuous beginning of fever. It can be due to bacterias, viruses, and less possibility that it is caused by fungi and auto immune response. In lowering fever, anti- pyretics can lower down the fever, but aspirin in the management of febrile illness especially in children has been controversial. It has been suggested that Aspirin may cause complications and its use should be restricted to treat acute febrile viral illness in children. The primary matter connected with aspirin is Reye syndrome. Stated in 1963, Reye syndrome is a non inflammatory and a toxicity that comes after illness caused by virus1. However its connection with aspirin treatment in case-control studies, correct diagnosis of Reye syndrome is quite challenging. The role of aspirin in the development of Reye syndrome is not clear, viral infection is supposed to be responsible to cause this syndrome1.
Several investigations have been performed to find out connection between Apirin and Reye’s Syndrome. Although, its mechanism of action is still unclear. Studies showed different factors excepting aspirin exposure and viral illness involvement because all children with viral illness subjected to aspirin will not develop Reye’s syndrome. Mitochondrial damage seems to be responsible for the symptoms, at least in the liver. During Reye’s Syndrome several mitochondrial pathways appears to be obstructed. Obstruction of fatty acid β oxidation and oxidative phosphorylation is supposed to be responsible for failure of mitochondria. Many methods in which which ability of aspirin to cause injury in mitochondrial have been proposed. Poisonous effect on seperated mitochondria of rat has been shown by aspirin, comprising noncoupling of oxidative phosphorylation leading to inhibition of fatty acid oxidation and depressing urea synthesis2. These effects leads to changes in morphology, compatible as seen in Reye’s Syndrome. Settlement of the immunal response by obstructing the transformation of lymphocyte and generation of interferon has been shown by aspirin. Also it has been shown that aspirin increases the release of TNF that is tumour necrosis factor. This TNF obstructs oxidation of fatty acid and this causes injury in mitochondria. Reye’s Syndrome patients fibroblasts have been found greatly susceptible to obstruction of β oxidation by aspirin than control cells2.
Aspirin is a Non-steroidal anti-inflammatory drugs (NSAIDs). Antibiotics are generally used for bacterial infections, but in recent years, due to the increased resistance of many bacteria to the commonly used antimicrobial agents, attention has shifted to drugs belonging to different pharmacological...