Antipyretic Therapy

Plaisance, Karen I.; Mackowiak, Philip A.

doi:10.1001/archinte.160.4.449

Cited by 122 publications

(42 citation statements)

References 89 publications

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“…Outcome measures included parental knowledge, confidence, behavior, and anxiety. In addition, information regarding the content for an educational intervention was distilled from previously mentioned studies and from guidelines proposing evidence‐based educational content about fever (AAP et al., ; El‐Radhi, ; National Institute for Health and Clinical Excellence [NICE], ).…”

Section: Health Literacy and Parental Skillmentioning

confidence: 99%

“…There is insufficient evidence that external cooling benefits the child (Meremikwu & Oyo-Ita, 2009;Watts, Robertson, & Thomas, 2003). In fact, it induces shivering and may increase the body temperature because of vasoconstriction (Plaisance & Mackowiak, 2000). Alcohol baths have also been associated with alcohol poisoning from inhaling alcohol vapors (Axelrod, 2000).…”

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confidence: 99%

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Empowering parents for evidence-based fever management: An integrative review

Monsma¹,

Richerson²,

Sloand

2015

Journal of the American Association of Nurse Practitioners

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Purpose Many parents of young, febrile children lack evidence‐based tools to manage fever (knowledge, skills, confidence, support), fear negative outcomes, and prioritize the reduction of fever over management of its source. This review examines the literature for evidence of factors that must be considered when designing effective fever management educational interventions for parents, especially those whose health literacy is low. Data sources A systematic search identified studies from 1980 to 2011 using the databases PubMed, CINAHL, Embase, Cochrane Review, Web of Science, PsychInfo, Medline Plus, Joanna Briggs Institute, and Google Scholar. Conclusions The most effective educational interventions are 1:1, multidimensional, structured, relevant, and reinforced over time. Parental culture, health literacy, knowledge deficits, and beliefs must be addressed by nurse practitioners (NPs) to maximize evidence‐based behaviors. Implications for practice Parents often strive to do what is best for their child but may become overly protective and anxious when managing their child's fever. NPs have a prime opportunity to improve parents’ fever management practices. An evidence‐based toolkit, created with respect for those who may have low health literacy, will give parents tangible tools to help them provide safer and less costly care for their febrile child.

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Section: Health Literacy and Parental Skillmentioning

confidence: 99%

mentioning

confidence: 99%

Empowering parents for evidence-based fever management: An integrative review

Monsma¹,

Richerson²,

Sloand

2015

Journal of the American Association of Nurse Practitioners

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“…Fever and pain are frequent in infants and children of all ages, and represent more than 30% of all of the complaints referred to pediatricians [ 1 , 2 , 3 ]. It is well known that fever is part of the body’s natural response to infections and inflammatory or immunological disorders [ 4 ]. As it is still a cause of considerable concern for health care providers (HCPs) and parents [ 1 , 5 , 6 ], efforts have been made to provide guidelines for its management throughout the world [ 2 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Fever and Pain Management in Childhood: Healthcare Providers’ and Parents’ Adherence to Current Recommendations

Raffaeli

Orenti

Gambino

et al. 2016

IJERPH

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In order to evaluate the adherence of healthcare providers and parents to the current recommendations concerning fever and pain management, randomized samples of 500 healthcare providers caring for children and 500 families were asked to complete an anonymous questionnaire. The 378 health care providers (HCPs) responding to the survey (75.6%) included 144 primary care pediatricians (38.1%), 98 hospital pediatricians (25.9%), 62 pediatric residents (16.4%), and 71 pediatric nurses (19.6%); the 464 responding parents (92.8%) included 175 whose youngest (or only) child was ≤5 years old (37.7%), 175 whose youngest (or only) child was aged 6–10 years (37.7%), and 114 whose youngest (or only) child was aged 11–14 years (24.6%). There were gaps in the knowledge of both healthcare providers and parents. Global adherence to the guidelines was lower among the pediatric nurses than the other healthcare providers (odds ratio 0.875; 95% confidence interval 0.795–0.964). Among the parents, those of children aged 6–10 and 11–14 years old, those who were older, and those without a degree answered the questions correctly significantly less frequently than the others. These findings suggest that there is an urgent need to improve the dissemination of the current recommendations concerning fever and pain management among healthcare providers and parents in order to avoid mistaken and sometimes risky attitudes, common therapeutic errors, and the unnecessary overloading of emergency department resources. Pediatric nurses and parents with older children, those who are older, and those with a lower educational level should be the priority targets of educational programmes.

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“…On the other hand, febrile response involves activation of immunologic, endocrinologic and other physiologic systems [7,8]. The response is generally beneficial, because such responses promote clearance of pathogenic microorganisms and hence improve outcome during infections [9].…”

Section: Introductionmentioning

confidence: 99%

Randomized trial of the effect of intravenous paracetamol on inflammatory biomarkers and outcome in febrile critically ill adults

et al. 2012

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Background and the purpose of the studyThe febrile reaction is a complex response involving immunologic and other physiologic systems. Antipyretics are commonly used in critically ill patients with fever. We investigated the inflammatory responses following application of antipyretic therapy in febrile critically ill patients with Systemic Inflammatory Response Syndrome (SIRS).Patients and methodsIn a prospective, randomized controlled study, critically ill patients with fever (T ≥ 38.3°C), SIRS diagnosed within 24 hours of Intensive Care Unit (ICU) admission and Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥10 were randomized into two groups. Upon appearance of fever, one group received intravenous paracetamol 650 mg every 6 hours for 10 days and other group received no treatment unless temperature reached 40°C. Body temperature, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sepsis-related Organ Failure Assessment (SOFA) scores, length of ICU stay, ICU mortality and infectious complications were recorded. Levels of Interleukin-1 alpha (IL-1α), IL-6, IL-10, Tumour Necrosis Factor alpha (TNFα) and High-Sensitive C-Reactive Protein (HS-CRP) were assessed at baseline and 2, 6 and 24 hours after intervention.Results and discussionDuring a period of 15-month screening, 20 patients met the criteria and randomized to the control or paracetamol group. Body temperature decreased significantly in the paracetamol group (p = 0.004) and control group (p = 0.001) after 24 hours, but there was no significant difference between two groups at this time point (p = 0.649). Levels of IL-6 and IL-10 decreased significantly (p = 0.025 and p = 0.047, respectively) in the paracetamol group at 24 hours but this was not of statistical significance in control group. No patterns over time in each group or differences across two groups were found for HS-CRP, TNFα, and IL-1α (p > 0.05). There were no differences regarding ICU length of stay, mortality and infectious complications between both groups.ConclusionThese results suggest that antipyretic therapy may not be indicated in all ICU patients. Allowing fever to take its natural course does not appear to have detrimental effects on critically ill patients with SIRS and may avoid unnecessary expenses.

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Antipyretic Therapy

Cited by 122 publications

References 89 publications

Empowering parents for evidence-based fever management: An integrative review

Empowering parents for evidence-based fever management: An integrative review

Fever and Pain Management in Childhood: Healthcare Providers’ and Parents’ Adherence to Current Recommendations

Randomized trial of the effect of intravenous paracetamol on inflammatory biomarkers and outcome in febrile critically ill adults

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