Correlating Changes in Body Temperature With Infectious Outcome in Febrile Children Who Receive Acetaminophen

Abstract

We reviewed the body-temperature patterns of 140 children ages 2 to 24 months who had fever > or = 39.0 degrees C, received acetaminophen 10 to 15 mg/kg, and had their temperatures remeasured 60 to 90 min later. The children comprised three groups: 22 had bacterial meningitis; 59, isolated bacteremia; and 59, nonbacterial febrile illness. Percentages of patients who became afebrile (temperature < 38.0 degrees C) after receiving acetaminophen were not significantly different among the three groups. Differences in mean temperature decrease after antipyretic was given were significant within each group but not between groups. An inverse relation (P < .004) between patient age and magnitude of temperature was revealed by the following formula: degrees C of defervescence = 1.66 - (0.028 x patient age in months). Thus, highly febrile young children with and without invasive bacterial infections who receive a therapeutic dose of acetaminophen experience a significant temperature drop after 60 to 90 min but do not commonly defervesce to an afebrile state. The degree of defervescence is age-dependent and does not distinguish between infectious outcomes.

Perception of fever and management practices by parents of pediatric patients

“…The beneficial properties of paracetamol as an antipyretic are well reported. 11,12 Singhi found that 57% of parents used paracetamol 13 , which is consistent (69.51%) with present study, but initial consultation rate was less (17.07%) than previous study where (63%) parents thought they should consult a doctor before starting treatment. 13 At the time of admission Temperature were normal in 22(13.41%) patients, alike Blumenthal 14 found the most parents did not know what a normal temperature was, and believed that untreated fever caused brain damage.…”

Effect of Recent Antipyretic Use on Measured Fever in the Pediatric Emergency Department

“…[2][3][4] Antipyretic medications are often used with fevers, and ample data indicate that antipyretics are effective in reducing fever. [5][6][7][8][9][10][11][12][13][14] If diagnostic decisions about in-fants with acute illness are based solely on the measured temperature at arrival without considering whether antipyretic drugs have recently been used, some cases of fever may be missed or the true level of the fever may not be appreciated. Some diagnoses of serious infections may be missed as a result.…”

Nurse Practitioners' Treatment of Febrile Infants in Utah: Comparison to Physician Practice Nationally

“…The response of febrile infants to antipyretics is not a reliable marker of SBI, as once believed, even in infants with a fever greater than 40.0 º C (Baker, Fosarelli, & Carpenter, 1987;Bonadio, Bellomo, Brady, & Smith, 1993). Interestingly, 6% of infants less than three months of age have a baseline temperature of 38.0 º C without illness (Herzog & Coyne, 1993).…”