To the Editor.

The study reported by Ploin et al1 was well-designed, well-executed, and clearly demonstrated the equivalent effect of albuterol given with a spacer device and with a nebulizer. A small detail caught my eye, and may have bothered other North American pediatricians practicing since at least the 1970s, namely the administration of aspirin to febrile children with viral infections. The literature on Reye's syndrome, recently summarized in editorials by Monto2 and by Sarnaik,3 is virtually unanimous that aspirin is a major risk factor for developing Reye's syndrome, especially in the presence of a viral illness.

If—and it is a major “if”—fevers of ≥38.0°C need treatment and do not respond to acetaminophen, ibuprofen is a safer choice.

In Reply.

Reye's syndrome has been related to aspirin intake in children, but the definitive causal relationship is still lacking. As Orlowski1 demonstrated in 1999, most cases of...

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