Effectiveness and tolerability of ibuprofen-arginine versus paracetamol in children with fever of likely infectious origin

Nadal, C. Figueras; Miguel, Ma J García de; Campderá, A Gómez; Fernández, Jordi Pou i; Calatayud, Guillermo Álvarez; Bayle, Marciano Sánchez

doi:10.1080/080352502317371607

Cited by 12 publications

(12 citation statements)

References 19 publications

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“…Fever is one of the common symptoms managed by health care providers and one of the leading reasons children and infants present for medical evaluation, accounting for nearly 65% ambulatory pediatric visits and frequently leading to the administration of antipyretic medications [ 1 – 3 ]. Indications for initiating antipyretic therapy are a temperature higher than 38.3° Celsius (C) [101°Fahrenheit (F)] and improving the child’s overall comfort [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

A multicenter, randomized, open-label, active-comparator trial to determine the efficacy, safety, and pharmacokinetics of intravenous ibuprofen for treatment of fever in hospitalized pediatric patients

Khalil¹,

Hahn

Chumpitazi

et al. 2017

BMC Pediatr

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BackgroundOral antipyretics are commonly used to treat pediatric patients who develop fevers. However, patients presenting to the emergency department or undergoing surgery are frequently unable to tolerate oral antipyretics. Rectal formulations are available; however, this route of administration is unpredictable. The main objectives of this randomized controlled study was to evaluate the efficacy and safety of single or multiple doses of intravenous ibuprofen to acetaminophen (oral or suppository) in pediatric patients with fever and to assess plasma ibuprofen concentrations.MethodsThis multi-center study was conducted in hospitalized patients, ≤ 16 years, with a new onset of fever ≥ 38.3°C. Patients were randomly assigned to receive either 10 mg/kg intravenous ibuprofen or acetaminophen. Study drug was administered at hour 0, and thereafter every 4 h as needed, up to 5 days. The primary outcome was to evaluate the effect of a single dose of intravenous ibuprofen compared to acetaminophen in reducing temperature in the first 2 h after administration. Data were compared using an analysis of variance model for continuous measurements and Cochran-Mantel-Haenszel test of general association for categorical data. A two-sided testing was used and a p-value ≤ 0.05 was considered significant.ResultsA total of 103 patients received study medication. Intravenous ibuprofen resulted in a greater reduction in temperature as measured by the area under the change from baseline at 2 h (p = 0.005) and 4 h (<0.001); in a greater reduction in change from baseline temperature compared to treatment with acetaminophen, and it reduced fever throughout a 24 h dosing period. There were no differences in safety parameters or serious adverse events.ConclusionsA single 10 mg/kg dose of intravenous ibuprofen provided a significant reduction of temperature for febrile pediatric patients compared to those that received 10 mg/kg acetaminophen at 2 h and 4 h post-treatment. A reduction in temperature was also demonstrated over 24 h; however the reduction was not considered statically significant. Intravenous ibuprofen provides an effective option for reducing fever in hospitalized pediatric patients.Trial registrationThe study was registered on ClinicalTrials.gov on 26 October 2009, Study Identifier: NCT01002573 Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-017-0795-y) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

A multicenter, randomized, open-label, active-comparator trial to determine the efficacy, safety, and pharmacokinetics of intravenous ibuprofen for treatment of fever in hospitalized pediatric patients

Khalil¹,

Hahn

Chumpitazi

et al. 2017

BMC Pediatr

View full text Add to dashboard Cite

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“…Fever is one of the most common complaints of children managed by pediatricians and other health care providers, and is the cause of nearly 65% of ambulatory paediatric visits [1]. Although fever is a beneficial host response, it is an important cause of anxiety for parents and leads to undue and excessive use of antipyretics [2,3].…”

Section: Introductionmentioning

confidence: 99%

A current analysis of caregivers’ approaches to fever and antipyretic usage

Polat

Kara

Tezer

et al. 2014

J Infect Dev Ctries

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Introduction: The aim of this survey was to investigate the current knowledge, attitudes, and practices of febrile children's caregivers about fever, antipyretic usage, and temperature measurement methods in a tertiary care hospital. Methodology: A 41-item questionnaire was administered to a convenience sample of febrile children's caregivers in face-to-face interviews by two research assistants from January 2012 through June 2012 in an urban region of Turkey. Results: A total of 1,032 caregivers completed the interview. Approximately one-third of caregivers considered a temperature of less than 37.8°C (100°F) to be a fever, and 13% of all respondents would give antipyretics for a body temperature ≤ 37.8°C. Furthermore, 76% of parents would wake their children from sleep to administer antipyretics. Although a high proportion (89.5%) of respondents believed that fever had harmful effects, 10.5% considered fever to be beneficial. Alternating use of acetaminophen and ibuprofen (44%) and giving antipyretics routinely (71%) before and after immunizations were common parental practices and generally advised by pediatricians. Parents with higher levels of education were more likely to consider fever to be beneficial and to treat fever with antipyretics, and less likely to seek medical attention for mild fever. Most caregivers stated that they were unsure about the right site (90%) and thermometer type (95%) for temperature measurement. Conclusions: Persistent fever anxiety and excessive antipyretic usage may be heightened by the lack of knowledge regarding accurate temperature measurement methods with digital thermometers in our population. Parental education may positively affect the approach to fever and antipyretic usage.

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“…Fever is one of the most common presenting complaints in paediatrics and general practice and is the cause of nearly 70% of all paediatric visits (1). A number of studies have investigated parents' knowledge, perceptions, theories and practices of childhood fever (2-5).…”

Section: Introductionmentioning

confidence: 99%

Knowledge and management of fever among Moroccan parents

Rkain¹,

Rkain²,

Safi³

et al. 2014

East Mediterr Health J

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Parents often have misperceptions about childhood fever, and little information is available about the home management of feverish children in Morocco. In this study of the perceptions, knowledge and practices of families regarding children's fever, the parents of 264 febrile children aged 0-16 years were interviewed in a paediatric emergency department in Rabat in 2011. Only 3.5% of parents knew the correct temperature definition for fever, 54.4% determined their children's fever using a thermometer, and the preferred site was rectal. Most of them (96.8%) considered that fever was a very serious condition, which could lead to side-effects such as brain damage (28.9%), seizures (18.8%) paralysis (19.5%), dyspnoea (14.8%) and coma (14.8%). Paracetamol was used by 85.9% and traditional treatments by 45.1%. Knowledge about the correct definition of fever was significantly associated with parents' profession, educational level and receipt of previous information and advice from health professionals. (14,8 %). Le paracétamol a été utilisé par 85,9 % des parents et les traitements traditionnels par 45,1 %. La connaissance de la définition exacte de la fièvre était significativement associée à la profession des parents, à leur niveau d'études et à la prise de conseils et d'informations préalable auprès des professionnels de santé.

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Effectiveness and tolerability of ibuprofen-arginine versus paracetamol in children with fever of likely infectious origin

Abstract: Based on the present results, ibuprofen-arginine oral drops have shown to be a safe, well-tolerated and potent paediatric antipyretic agent. Hence, ibuprofen-arginine should be considered as an adequate choice for the control of paediatric fever of likely infectious aetiology.

Cited by 12 publications

References 19 publications

A multicenter, randomized, open-label, active-comparator trial to determine the efficacy, safety, and pharmacokinetics of intravenous ibuprofen for treatment of fever in hospitalized pediatric patients

A multicenter, randomized, open-label, active-comparator trial to determine the efficacy, safety, and pharmacokinetics of intravenous ibuprofen for treatment of fever in hospitalized pediatric patients

A current analysis of caregivers’ approaches to fever and antipyretic usage

Knowledge and management of fever among Moroccan parents

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