Evaluation of sponging and antipyretic medication to reduce body temperature in febrile children

Abstract

TWO hundred and twenty-four children aged 6 months to 5 years, with rectal temperatures greater than or equal to 39°C (104°F). were randomly treated with sponging alone or with medication including a single oral dose of aspirin 15 mgkg, or paracetamol 15 m a g , or ibuprofen 8 m a g . Twenty-three children were excluded from the final analysis because they did not complete the study. Demographic characteristics of the patients were found to be comparable in all groups. Rectal temperatures were recorded every 30 min for a 3 h period. During the first 30 min of intervention, sponging was found to be more effective than all of the three medications. After 60 min, the effects of each medication became superior to sponging with tepid water in reducing body temperature. Twenty-three children were excluded from the final analysis because they did not complete the study. Comparing the effect of the three different medications, it was seen that the antipyretic efficacy of aspirin and ibuprofen were significantly more than paracetamol 3 h after intervention ( P < 0.05).For the management of fever over 39°C it is therefore recommended to give children an antipyretic drug, preferably ibuprofen, and at the same time to begin sponging to provide a rapid and sustained antipyresis.

Tepid sponging plus dipyrone versus dipyrone alone for reducing body temperature in febrile children

“…18 In some studies, the effects of paracetamol or ibuprofen became superior to sponging after 60 minutes. 8,11 In our study, we also observed lower axillary temperatures with dipyrone alone after this length of time, and there was also an increase in axillary temperature after 120 minutes. This can be explained as a rebound reaction because, unlike antipyretics, external cooling acts not by reducing the elevated set point but by overwhelming the metabolically expensive effector mechanisms that have been evoked by the elevated set-point.…”

“…8,9,11 In a review, Bernath et al concluded that tepid sponging appears to be more effective within the first 30 minutes of treatment and has an additive effect when combined with paracetamol. 18 In some studies, the effects of paracetamol or ibuprofen became superior to sponging after 60 minutes.…”

“…9 However, tepid sponging with paracetamol achieves better antipyretic effects than the drug alone. [10][11][12] Dipyrone, a pyrazolone nonsteroidal anti-infl ammatory agent, is available in many parts of the world, including the Far East, Africa and Latin America. In the latter region, it is the antipyretic that is most used, and its effectiveness and safety have recently been certifi ed in Brazil and Mexico.…”

Acetaminophen and ibuprofen

“…A 1976 study showed that ibuprofen 6 mg/kg was as effective as APAP 12.5 mg/kg (15). APAP 15 mg/kg has been compared with ibuprofen 2.5 to 10 mg/kg in three studies (17)(18)(19). At this dose, APAP was superior to low doses of ibuprofen (2.5 to 5 mg/kg) but equivalent to higher doses (7.5 to 10 mg/kg).…”

Nursing interventions in the prevention of febrile seizures

“…Six studies (Agbolosu, et al, 1997;Aksoylar et al, 1997;Brandts, 1997;Freidman & Barton, 1990;Kinmonth, 1992;& Steele, 1970;) examined the use of acetaminophen only as compared to sponging. All six reported acetaminophen alone reduced the fever more compared to sponging; however, only three studies (Agbolosu, et al, 1997;Freidman & Barton, 1990;Aksoylar et al, 1997) reported any statistical (p = <0.05) data.…”