Antipyretic Efficacy of Ibuprofen and Acetaminophen in Children With Febrile Seizures

Esch, Adrianus van; Steensel-Moll, H A van; Offringa, Martin; Habbema, J. Dik F.; Derksen‐Lubsen, Gerarda

doi:10.1001/archpedi.1995.02170190042007

Cited by 100 publications

(62 citation statements)

References 21 publications

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“…Studies in which the effectiveness of ibuprofen and acetaminophen were compared have yielded variable results; the consensus is that both drugs are more effective than placebo in reducing fever and that ibuprofen (10 mg/kg per dose) is at least as effective as, and perhaps more effective than, acetaminophen (15 mg/kg per dose) in lowering body temperature when either drug is given as a single or repetitive dose. [52][53][54][55][56][57] Data also show that the height of the fever and the age of the child (rather than the specific medication used) may be the primary determinants of the efficacy of antipyretic therapy; those who have a higher fever and are older than 6 years show decreased efficacy or response to antipyretic therapy. 54 Studies that compare the effect of ibuprofen versus acetaminophen on children's behavior and comfort are generally lacking.…”

Section: Ibuprofenmentioning

confidence: 99%

Fever and Antipyretic Use in Children

Sullivan¹,

Farrar²

2011

Pediatrics

366

313

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Fever in a child is one of the most common clinical symptoms managed by pediatricians and other health care providers and a frequent cause of parental concern. Many parents administer antipyretics even when there is minimal or no fever, because they are concerned that the child must maintain a “normal” temperature. Fever, however, is not the primary illness but is a physiologic mechanism that has beneficial effects in fighting infection. There is no evidence that fever itself worsens the course of an illness or that it causes long-term neurologic complications. Thus, the primary goal of treating the febrile child should be to improve the child's overall comfort rather than focus on the normalization of body temperature. When counseling the parents or caregivers of a febrile child, the general well-being of the child, the importance of monitoring activity, observing for signs of serious illness, encouraging appropriate fluid intake, and the safe storage of antipyretics should be emphasized. Current evidence suggests that there is no substantial difference in the safety and effectiveness of acetaminophen and ibuprofen in the care of a generally healthy child with fever. There is evidence that combining these 2 products is more effective than the use of a single agent alone; however, there are concerns that combined treatment may be more complicated and contribute to the unsafe use of these drugs. Pediatricians should also promote patient safety by advocating for simplified formulations, dosing instructions, and dosing devices.

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Section: Ibuprofenmentioning

confidence: 99%

Fever and Antipyretic Use in Children

Sullivan¹,

Farrar²

2011

Pediatrics

366

313

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“…[2,[8][9][10][11][12][13][14] (Evidence A) • The practices of combining or alternating paracetamol and ibuprofen have limited value and are not recommended. [15,16] (Evidence B) • Mefenamic acid is registered for use from 6 months of age and may be an alternative non-steroidal anti-inflammatory (NSAID) to ibuprofen in children with fever.…”

Section: Antipyretic Medicationmentioning

confidence: 99%

Management of acute fever in children: Guideline for community healthcare providers and pharmacists

et al. 2013

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Fever is a normal physiological response to illness that facilitates and accelerates recovery. Although it is often associated with a self-limiting viral infection in children, it may also be a presenting symptom of more serious conditions requiring urgent medical care. Therefore, it is essential to distinguish between a child with fever who is at high risk of serious illness and who requires specific treatment, hospitalisation or specialist care, and those at low risk who can be managed conservatively at home. This guideline aims to assist pharmacists, primary healthcare workers and general practitioners in risk-stratifying children who present with fever, deciding on when to refer, the appropriate use of antipyretic medication and how to advise parents and caregivers.

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“…As with acetaminophen, ibuprofen also has been shown to be ineffective in preventing recurrence of febrile seizures. [33][34][35] In general, acetaminophen and ibuprofen are considered to be safe and effective antipyretics for children. However, hepatotoxicity (with acetaminophen) and respiratory failure, metabolic acidosis, renal failure, and coma (with ibuprofen) have been reported in children after overdose or in the presence of risk factors.…”

Section: Benefits and Risks Of Intermittent Antipyreticsmentioning

confidence: 99%

Febrile Seizures: Clinical Practice Guideline for the Long-term Management of the Child With Simple Febrile Seizures

Seizures¹

2008

Pediatrics

299

121

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Febrile seizures are the most common seizure disorder in childhood, affecting 2% to 5% of children between the ages of 6 and 60 months. Simple febrile seizures are defined as brief (Ͻ15-minute) generalized seizures that occur once during a 24-hour period in a febrile child who does not have an intracranial infection, metabolic disturbance, or history of afebrile seizures. This guideline (a revision of the 1999 American Academy of Pediatrics practice parameter [now termed clinical practice guideline] "The Long-term Treatment of the Child With Simple Febrile Seizures") addresses the risks and benefits of both continuous and intermittent anticonvulsant therapy as well as the use of antipyretics in children with simple febrile seizures. It is designed to assist pediatricians by providing an analytic framework for decisions regarding possible therapeutic interventions in this patient population. It is not intended to replace clinical judgment or to establish a protocol for all patients with this disorder. Rarely will these guidelines be the only approach to this problem. Pediatrics 2008;121:1281-1286The expected outcomes of this practice guideline include:1. optimizing practitioner understanding of the scientific basis for using or avoiding various proposed treatments for children with simple febrile seizures;2. improving the health of children with simple febrile seizures by avoiding therapies with high potential for adverse effects and no demonstrated ability to improve children's long-term outcomes; 3. reducing costs by avoiding therapies that will not demonstrably improve children's long-term outcomes; and 4. helping the practitioner educate caregivers about the low risks associated with simple febrile seizures.The committee determined that with the exception of a high rate of recurrence, no long-term effects of simple febrile seizures have been identified. The risk of developing epilepsy in these patients is extremely low, although slightly higher than that in the general population. No data, however, suggest that prophylactic treatment of children with simple febrile seizures would reduce the risk, because epilepsy likely is the result of genetic predisposition rather than structural damage to the brain caused by recurrent simple febrile seizures. Although antipyretics have been shown to be ineffective in preventing recurrent febrile seizures, there is evidence that continuous anticonvulsant therapy with phenobarbital, primidone, or valproic acid and intermittent therapy with diazepam are effective in reducing febrile-seizure recurrence. The potential toxicities associated with these agents, however, outweigh the relatively minor risks associated with simple febrile seizures. As such, the committee concluded that, on the basis of the risks and benefits of the effective therapies, neither continuous nor intermittent anticonvulsant therapy is recommended for children with 1 or more simple febrile seizures. INTRODUCTIONFebrile seizures are seizures that occur in febrile children between the ages of 6 and 6...

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Antipyretic Efficacy of Ibuprofen and Acetaminophen in Children With Febrile Seizures

Cited by 100 publications

References 21 publications

Fever and Antipyretic Use in Children

Fever and Antipyretic Use in Children

Management of acute fever in children: Guideline for community healthcare providers and pharmacists

Febrile Seizures: Clinical Practice Guideline for the Long-term Management of the Child With Simple Febrile Seizures

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