A 16-year old child has been diagnosed with rheumatic fever. He now has painful migratory polyarthritis. The physician has decided to give penicillin for the RF, but should he also prescribe aspirin for the painful polyarthritis or would this increase the risk of Reye syndrome?
I apologize for not copying the question as-is from Kaplan Qbank, because I think this would violate copyrights.
That's what I've been eager to hear! And that's exactly what I sent to Kaplan medfeedback about this question. The designated right answer was penicillin + aspirin, but I did not agree.
I emailed Kaplan about this, and here's their reply:
Even though aspirin use is found to be related to REYE'S syndrome in the children with viral infection, Aspirin is also the major anti-inflammatory agent for relief of symptoms due to acute rheumatic fever. No doubt we should use aspirin cautiously in children and that is why it is advised as you can see from link you referred to that the opinion of a doctor or pharmacist be obtained before anyone under 19 years of age is given any medication containing aspirin.
Well, I am sorry but the reply from Kaplan is totally frustrating. What we need to know is exactly what's the opinion that the doctor or pharmacist will have! I will go with the FDA. It's better to use an inferior NSAID than aspirin than cause fulminant hepatitis
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