Abstract In this systematic review, we aimed to assess the efficacy and safety of nonsteroidal anti‐inflammatory drugs (NSAIDs) in treating respiratory tract infections in adults and children. PubMed, Scopus, Web of Science, Cochrane, and Embase databases were searched. A total of 34 randomized clinical trials were included in this systematic review. We assessed the risk of bias of all included studies using the Cochrane tool for risk of bias assessment. The evidence on ibuprofen, naproxen, aspirin, diclofenac, and other NSAIDs were rated for degree of uncertainty for each of the study outcomes and summarized using the grading of recommendations assessment, development, and evaluation (GRADE) approach. Our findings suggest that high‐quality evidence supports the use of NSAIDs to reduce fever in both adults and children. However, the evidence was uncertain for the use of NSAIDs to reduce cough. Most studies showed that NSAIDs significantly relieved sore throat. The evidence for mortality and oxygenation is limited. Regarding the adverse events, gastrointestinal discomfort was more frequently reported in children. For adults, our overall certainty in effect estimates was low and the increase in gastrointestinal adverse events was not clinically significant. In conclusion, NSAIDs seem to be beneficial in the outpatient management of fever and sore throat in adults and children. Although the evidence does not support their use to decrease mortality nor improve oxygenation in inpatient settings, the use of NSAIDs did not increase the rate of death or the need for ventilation in patients with respiratory tract infections. Further studies with a robust methodology and larger sample sizes are recommended. A visual summary of efficacy and safety of NSAIDs in acute viral respiratory tract infections.
【저자키워드】 Coronavirus disease 2019, acute respiratory distress syndrome, systematic review, Acute respiratory tract infections, nonsteroidal anti‐inflammatory drugs, 【초록키워드】 randomized clinical trial, Mortality, children, Ventilation, respiratory tract infection, drug, cough, database, Respiratory tract infections, NSAIDS, adverse events, Adults, infections, management, Fever, adverse event, Patient, death, Aspirin, Efficacy and safety, methodology, estimate, Evidence, NSAID, Oxygenation, Support, sore throat, Web of Science, Sample size, MOST, recommendation, approach, decrease, robust, IMPROVE, significantly, reported, clinically, searched, increase in, reduce, viral respiratory, risk of bia, study outcome, 【제목키워드】 drug, viral respiratory, Nonsteroidal,