Virtual Conference
Pharma Conference 2022

Nima Azh

Iran University of Medical Sciences, Iran

Title: Nonsteroidal Anti-inflammatory Drugs in Acute Viral Respiratory Tract Infections: An Updated Systematic Review


Introduction: Acute viral infections of the respiratory tract (ARTIs) are the most common diseases at any age that cause a range of inflammation - from localized irritation of the mucosa to extensive lung involvement and cytokine storm. Various non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed in the first line to combat inflammation. However, which NSAIDs are most effective in a child with a sore throat or an adult with a severe cough? We reviewed and compared the effectiveness of each NSAID on different symptoms so that the physician could tailor treatment to each patient's symptoms based on evidence. 

Methods: By comprehensive search of PubMed, Scopus, Web of Science, Cochrane and Embase databases, randomized clinical trial studies were identified and analyzed using the recommendation grading method, development and evaluation (GRADE). Were reported. Meta-analysis was performed in the absence of heterogeneity.

34 randomized clinical trials were identified and analyzed. 12 articles were extracted for ibuprofen, 9 articles for aspirin, 3 articles for diclofenac, 4 articles for naproxen and 6 articles for other NSAIDs. Evidence was categorized based on symptoms of fever, cough, sore throat, length of hospital stay, mortality, oxygen demand, and gastrointestinal side effects for each NSAID in GRADEpro tables.

All NSAIDs are effective in lowering fever. Evidence for the effectiveness of NSAIDs for cough is weak and there is conflicting evidence for mild cough. Diclofenac and ibuprofen have strong and moderate efficacy in reducing sore throat, respectively; While the evidence of naproxen for sore throat has been reported to be weak and ineffective. Naproxen, along with other interventions, has been shown to reduce oxygen demand. The length of hospital stay was not reduced in any study. Evidence of mortality is weak and only naproxen has been reported to be effective. Side effects of ibuprofen are more common in children.


As a fan of biology, I took my diploma in biology from NODET high school for talented students. I followed my interest through a medical degree later at Iran University of Medical Sciences where I took my MD.  In a world of pseudoscience and overwhelming infodemics, I found MPH to be a trustworthy companion for my General Practice. I currently work towards excellence in General Practice, as well as Evidence Based Medicine.