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New advice for treating fever in young children |
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3 September 2008 | Ibuprofen reduces a child’s temperature faster and for longer than paracetamol, in the first four hours a child has a fever. If the fever persists, then children should be given ibuprofen plus paracetamol, according to a study published today online at BMJ.com. |
The work was carried out by the University of
Bristol and the University of the West of England, with support from the NHS in
Bristol. The children in the study were recruited from 35 Bristol primary care
sites, thanks to help from the local media in Bristol. The research shows that giving ibuprofen to
children under six reduced the amount of time they spent with fever in the first
four hours by 40 minutes, compared with giving paracetamol. |
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When both medicines were alternated
over a 24-hour period, children spent nearly 4.5 hours less time
with fever, compared with giving paracetamol on its own, and 2.5
hours less time with fever, when compared with giving ibuprofen on
its own. In light of this evidence the
authors say that national guidelines, which caution that the
medicines should not be used in combination, should be reviewed.
These guidelines were published last year by the National Institute
for Health and Clinical Excellence (NICE), Dr Alastair Hay, a Senior Lecturer
at Bristol University’s Department of Community-based Medicine and a
local GP, said: “Advice given to parents regarding which medicine to
use can be confusing, especially at a time when they are worried
about their child. Our NHS-funded ‘PITCH’ fever study set out to
investigate the most effective medicine for children unwell with a
fever – paracetamol, ibuprofen, or both. “If symptoms persist despite
ibuprofen, then alternating both medicines is probably superior to
using either medicine alone, but if two medicines are used, parents
need to be careful to avoid accidentally giving too much.” A team of researchers from the
University of Bristol and the University of the West of England,
recruited 156 children aged between six months and six years old who
had a temperature between 37.8 and 41 degrees centigrade, due to an
illness that could be managed at home. Children were randomised to
receive either paracetamol plus ibuprofen, just paracetamol, or just
ibuprofen. Using two medicines does not appear
to cost parents or the NHS any more than using one medicine. The
results also show that using both medicines may also be the least
expensive option for parents – because they took less time off work,
and for the NHS – because of fewer GP visits. Dr Hay added: “Children with a high
temperature should be lightly dressed and given plenty to drink.
When parents or healthcare professionals wish to use medicines to
help relieve symptoms, ibuprofen is the most effective in the first
4 hours. If more sustained symptom control over a 24-hour period is
wanted, giving both medicines alternately is better than giving one
on its own. “However, parents should keep a
careful record of when doses are given to avoid accidentally giving
too much. If a parent is concerned about the underlying cause for
their child’s fever, they should seek medical advice. I am very
grateful to the parents, children and local doctors and nurses who
supported the study and hope that they will help us with future
studies.” |
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| Source: http://www.bris.ac.uk/ | |||
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