Effect of Antipyretic Drugs in Children with Malaria

Abstract

A comparison of different antipyretics in children with malaria showed a small effect of naproxen, but not of metamizol, on the reduction of fever peaks. Antipyretic treatment had no effect on fever clearance and therefore should be used cautiously in the treatment of malaria.

Suppression of Prostaglandin E2by Malaria Parasite Products and Antipyretics Promotes Overproduction of Tumor Necrosis Factor–α: Association with the Pathogenesis of Childhood Malarial Anemia

“…Additional investigations of murine models of CM demonstrate that treatment with aspirin (a COX-1-selective inhibitor) and celecoxib (a COX-2-selective inhibitor) increase mortality and the early onset of CM, respectively [43,44]. Although the beneficial versus detrimental effects of antipyretic use during childhood malaria are largely unsubstantiated, previous case-control studies [45,46] illustrate that antipyretics, such as acetaminophen and naproxen, do not significantly reduce malarial fever, compared with mechanical fever-control measures (i.e., manual fanning) currently recommended by the World Health Organization [47]. The experimental results of the present study illustrate that all of the COX inhibitors resulted in high levels of TNF-a in the in vitro model, demonstrating that pharmacologic inhibition of COX through the use of antipyretics has the potential to elicit high TNF-a levels.…”

A Model for Estimating Total Parasite Load in Falciparum Malaria Patients

“…The second data set comprised the first 26 children of a larger study from Gabon (Lell et al, 2001). Each patient received quinine therapy and parasitaemia was recorded at the onset of treatment and then every 6 hr until no parasites were detected in the blood.…”

Antipyretic, Parasitologic, and Immunologic Effects of Combining Sulfadoxine/Pyrimethamine With Chloroquine or Paracetamol for Treating Uncomplicated Plasmodium Falciparum Malaria

“…However, paracetamol and other antipyretics have been recommended to be used with caution during P. falciparum malaria because of alleged poor antipyretic effects and delayed parasite clearance. 13,14 We wanted to conduct a more comprehensive study than those previously performed, including more frequent recording of temperature and correlating the anti-parasitic effect directly with the antipyretic effect of chloroquine. We also wanted to study a possible effect on the humoral immune response by chloroquine and paracetamol elicited by infection with P. falciparum.…”