Clinical Report—Fever and Antipyretic Use in Children

abstract
Fever in a child is one of the most common clinical symptoms managed
by pediatricians and other health care providers and a frequent cause
of parental concern. Many parents administer antipyretics even when
there is minimal or no fever, because they are concerned that the child
must maintain a “normal” temperature. Fever, however, is not the
primary illness but is a physiologic mechanism that has beneficial
effects in fighting infection. There is no evidence that fever itself worsens
the course of an illness or that it causes long-term neurologic
complications. Thus, the primary goal of treating the febrile child
should be to improve the child’s overall comfort rather than focus on
the normalization of body temperature. When counseling the parents
or caregivers of a febrile child, the general well-being of the child, the
importance of monitoring activity, observing for signs of serious illness,
encouraging appropriate fluid intake, and the safe storage of
antipyretics should be emphasized. Current evidence suggests that
there is no substantial difference in the safety and effectiveness of
acetaminophen and ibuprofen in the care of a generally healthy child
with fever. There is evidence that combining these 2 products is more
effective than the use of a single agent alone; however, there are concerns that combined treatment may bemore complicated and contribute to the unsafe use of these drugs. Pediatricians should also promote patient safety by advocating for simplified formulations, dosing instructions, and dosing devices.
Pediatrics 2011;127:580–587

Clinical Report—Fever and Antipyretic Use in Children

pediatrics.aappublications.org