Ibuprofen, Acetaminophen, or Steam for Respiratory Infections?

By Kelly Young

Steam inhalation and ibuprofen are not more likely than acetaminophen to relieve acute respiratory symptoms in most patients, according to a BMJ study.

Nearly 900 patients aged 3 and up presenting with acute respiratory infections were randomized to 12 groups that offered advice on the following:

• drugs: acetaminophen, ibuprofen, or alternating between the two

• dosing: regular (4 times daily for at least 3 days), or as needed

• steam: inhale 15 minutes daily, or no steam

Patient-reported symptom severity on days 2 to 4 did not differ significantly across the groups. Children and patients with lower respiratory infections were more likely to benefit from ibuprofen. However, new or unresolved symptoms or complications were more common with ibuprofen (20%) or alternating therapy (17%) than acetaminophen (12%).

The authors conclude that clinicians should not routinely recommend steam or regular medication dosing, adding: "They could consider ibuprofen use in patients with chest infections and those aged <16 who might selectively benefit."