Comparison of the Effects of Acetaminophen Plus Ibuprofen to Treat Fever Than any of the Two Alone in Febrile Children

Abstract

Background: Fever is a natural response of the host to infection and a normal part of children's infectious disease. Objectives: The purpose of the study was comparison of the combined treatment of acetaminophen and ibuprofen compact with each treatment alone. Methods: This Double-blind clinical trial study was done on 540 children with 38°C to 41°C as body temperature. Eligible children after considering inclusion criteria divided in three groups randomly. First group of 183 patients administrated with acetaminophen, the second and the third groups of 178 and 179 patients with ibuprofen and combination. The first dose of antipyretic drug was administered to the patient under the supervision of a physician or nurse. After explanation of benefits and marginal effects to the parents if they accepted the conditions their children were admitted to the study. Parents were free if they wish to withdraw the study before completing. Information of each patient was recorded on a form. The data were analyzed by descriptive statistic, one-way ANOVA and SPSS software version 16. Results: Out of sample 60.6% were boy. The mean age of children treated with acetaminophen, ibuprofen and combination therapy

Prescribing Controversies: An Updated Review and Meta-Analysis on Combined/Alternating Use of Ibuprofen and Paracetamol in Febrile Children

“…This review included three additional studies (36, 41, 42) compared to the 2013 Cochrane review. The included studies were nine RCTs, open or blinded.…”

“…For temperature measurement, two studies used axillary thermometers (41, 43), two studies used tympanometric thermometers (34, 36), one study used temporal artery thermometers (44), two studies used rectal thermometers (45, 46), and one study used oral thermometers with children >2 years old and rectal thermometers with children <2 years (47). One study did not mention the method used to assess body temperature (42).…”

“…In all studies, therapy was administered orally. Seven studies used paracetamol at dose of 15 mg/kg (34, 36, 42–45, 47), one study at a dose of 10 mg/kg (41) and one study at a dose of 12.5 mg/kg (46). Seven studies used ibuprofen at a dose of 10 mg/kg (36, 41–45, 47), two studies at a dose of 5 mg/kg (34, 46).…”

“…Four studies compared combined therapy vs. ibuprofen and paracetamol alone (34, 36, 42, 43), two studies compared alternating therapy vs. ibuprofen and paracetamol alone (41, 46), one study compared alternating therapy vs. ibuprofen alone (45), one study compared alternating therapy vs. paracetamol alone (47), one study compared combined and alternating therapy vs. ibuprofen alone and alternating vs. combined therapy (44).…”

“…Five studies (34, 36, 42–44) compared therapy with paracetamol and ibuprofen together at baseline and single agent therapy. Outcome measures were: proportion of children remaining febrile and mean temperature at one, 4 and 6 h from baseline.…”