Comparison of Multidose Ibuprofen and Acetaminophen Therapy in Febrile Children

Walson, Philip D.; Galletta, Gary; Chomilo, Fred; Braden, Nancy Jo; Sawyer, L.; Scheinbaum, Monte L.

doi:10.1001/archpedi.1992.02160170106025

Cited by 50 publications

(36 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Studies in which the effectiveness of ibuprofen and acetaminophen were compared have yielded variable results; the consensus is that both drugs are more effective than placebo in reducing fever and that ibuprofen (10 mg/kg per dose) is at least as effective as, and perhaps more effective than, acetaminophen (15 mg/kg per dose) in lowering body temperature when either drug is given as a single or repetitive dose. [52][53][54][55][56][57] Data also show that the height of the fever and the age of the child (rather than the specific medication used) may be the primary determinants of the efficacy of antipyretic therapy; those who have a higher fever and are older than 6 years show decreased efficacy or response to antipyretic therapy. 54 Studies that compare the effect of ibuprofen versus acetaminophen on children's behavior and comfort are generally lacking.…”

Section: Ibuprofenmentioning

confidence: 99%

Fever and Antipyretic Use in Children

Sullivan¹,

Farrar²

2011

Pediatrics

363

313

View full text Add to dashboard Cite

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 be more 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.

show abstract

Section: Ibuprofenmentioning

confidence: 99%

Fever and Antipyretic Use in Children

Sullivan¹,

Farrar²

2011

Pediatrics

363

313

View full text Add to dashboard Cite

show abstract

“…Detailed laboratory tests did not establish any abnormality of renal or liver function associated with the medicines. 62 In another trial randomising 116 children to paracetamol 10 mg/ kg or ibuprofen 10 mg/kg, two paracetamol-treated children vomited. 63 In another trial randomising 33 children to 10 mg/kg paracetamol, 32 to ibuprofen 5 mg/kg, 28 to ibuprofen 10 mg/kg and 34 to placebo, gastrointestinal symptoms were observed in the six paracetamol-treated children compared with 10 children treated with ibuprofen 5 mg/ kg, six in the ibuprofen 10 mg/kg group and two in the placebo group.…”

Section: Adverse Eventsmentioning

confidence: 99%

Paracetamol and ibuprofen for the treatment of fever in children: the PITCH randomised controlled trial

Hay

Redmond²,

Costelloe³

et al. 2009

Health Technol Assess

View full text Add to dashboard Cite

How to obtain copies of this and other HTA programme reports An electronic version of this publication, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable CD-ROM is also available (see below).Printed copies of HTA monographs cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our Despatch Agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in t...

show abstract

“…1 Among the available antipyretic agents, acetaminophen is one of the most widely used because it has an antipyretic efficacy equivalent to the other antipyretic drugs and a good safety profile. [2][3][4] Acetaminophen antipyretic efficacy is dose-dependent. 5,6 The recommended dose is 15 mg/kg every 6 hours.…”

mentioning

confidence: 99%

“…5,6 The recommended dose is 15 mg/kg every 6 hours. 2 Following this dosing schedule, it usually takes several hours after the first acetaminophen administration to obtain the maximal clinical efficacy of the drug. 7 Therefore, Mahar et al 8 suggested a physical "cold therapy" at the initiation of the chemical treatment to decrease the time course to antipyretic effect.…”

mentioning

confidence: 99%

Antipyretic Efficacy of an Initial 30-mg/kg Loading Dose of Acetaminophen Versus a 15-mg/kg Maintenance Dose

et al. 2001

View full text Add to dashboard Cite

ABSTRACT. Objective. To compare the antipyretic efficacy of an initial 30-mg/kg acetaminophen loading dose versus a 15-mg/kg maintenance dose.Methods. A double-blind, parallel-group, randomized clinical trial was conducted. A total of 121 febrile (rectal temperature between 39°C and 40°C) but otherwise healthy outpatients who were 4 months to 9 years of age and weighed 4 to 26 kg were assigned randomly to 1 of the dose groups: 15 mg/kg (n ‫؍‬ 62) and 30 mg/kg (n ‫؍‬ 59).Results. In an "intention to treat" analysis, the time to obtain a temperature lower than 38.5°C was significantly shorter in the 30-mg/kg than in the 15-mg/kg group (110 ؎ 94 minutes vs 139 ؎ 113 minutes). The maximum temperature decrease was significantly higher in the 30-mg/kg than in the 15-mg/kg group (2.3 ؎ 0.7°C vs 1.7 ؎ 0.6°C). Duration of rectal temperature below 38.5°C was significantly longer in the 30-mg/kg than in the 15-mg/kg group (250 ؎ 92 minutes vs 185 ؎ 121 minutes, respectively). Adverse events were reported in 6 children in the 30-mg/kg group compared with 5 in the 15-mg/kg group (hyperthermia, hypothermia, vomiting). The difference was not statistically significant.Conclusion. An initial 30-mg/kg acetaminophen loading dose seemed to be more effective in reducing fever than a 15-mg/kg maintenance dose. No difference was observed regarding clinical tolerance. These data suggest that acetaminophen treatment of fever may be more efficient in an initial loading dose. Pediatrics 2001;108(4). URL: http://www.pediatrics.org/cgi/content/full/108/4/ e73; fever, loading dose, acetaminophen, children.ABBREVATIONS. Teff: time to obtain a rectal temperature below 38°C; Rmax, maximum temperature decrease; Tmax, time to maximum temperature decrease.

show abstract

Comparison of Multidose Ibuprofen and Acetaminophen Therapy in Febrile Children

Cited by 50 publications

References 18 publications

Fever and Antipyretic Use in Children

Fever and Antipyretic Use in Children

Paracetamol and ibuprofen for the treatment of fever in children: the PITCH randomised controlled trial

Antipyretic Efficacy of an Initial 30-mg/kg Loading Dose of Acetaminophen Versus a 15-mg/kg Maintenance Dose

Contact Info

Product

Resources

About