Systematic review and meta-analysis of the effects of antipyretic medications on mortality in <i>Streptococcus pneumoniae</i> infections

Jefferies, Sarah; Weatherall, Mark; Young, Paul; Eyers, Sally; Beasley, Richard

doi:10.1136/postgradmedj-2011-130217

Cited by 14 publications

(10 citation statements)

References 43 publications

(50 reference statements)

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“…The benefits of hyperthermia has been most convincingly demonstrated in ectoderms such as reptiles and fish, in which deliberate exposure to higher environmental temperatures improved survival [ 19 ]. Correspondingly, in rabbits, mice, and chicks, antipyretic drugs repeatedly increased mortality rates from bacterial [ 22 ] and viral [ 23 ] infections. The evidence in humans is less conclusive, as large-scale blinded trials have not been performed [ 24 , 25 ].…”

Section: The Mystery—why Do We Feel Sick?mentioning

confidence: 99%

Why Do We Feel Sick When Infected—Can Altruism Play a Role?

Shakhar

2015

PLoS Biol

103

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When we contract an infection, we typically feel sick and behave accordingly. Symptoms of sickness behavior (SB) include anorexia, hypersomnia, depression, and reduced social interactions. SB affects species spanning from arthropods to vertebrates, is triggered nonspecifically by viruses, bacteria, and parasites, and is orchestrated by a complex network of cytokines and neuroendocrine pathways; clearly, it has been naturally selected. Nonetheless, SB seems evolutionarily costly: it promotes starvation and predation and reduces reproductive opportunities. How could SB persist? Former explanations focused on individual fitness, invoking improved resistance to pathogens. Could prevention of disease transmission, propagating in populations through kin selection, also contribute to SB?

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Section: The Mystery—why Do We Feel Sick?mentioning

confidence: 99%

Why Do We Feel Sick When Infected—Can Altruism Play a Role?

Shakhar

2015

PLoS Biol

103

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“…In fact, the use of antipyretics has been reported to prolong the evolution of certain types of bacterial and viral infections [96, 97]. Studies have shown a correlation between febrile response and increased survival rate in patients with community-acquired pneumonia, Escherichia coli, Streptococcus pneumonia, and Pseudomonas aeruginosa sepsis [98–101]. Fever also has the direct effect of inhibiting the replication of some microorganisms, and it enhances the antibacterial effect of a variety of antibiotics [102, 103].…”

Section: Changes In Brain Temperature In Neurointensive Carementioning

confidence: 99%

Brain Temperature: Physiology and Pathophysiology after Brain Injury

Mrozek

Vardon

Geeraerts

2012

Anesthesiology Research and Practice

138

128

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The regulation of brain temperature is largely dependent on the metabolic activity of brain tissue and remains complex. In intensive care clinical practice, the continuous monitoring of core temperature in patients with brain injury is currently highly recommended. After major brain injury, brain temperature is often higher than and can vary independently of systemic temperature. It has been shown that in cases of brain injury, the brain is extremely sensitive and vulnerable to small variations in temperature. The prevention of fever has been proposed as a therapeutic tool to limit neuronal injury. However, temperature control after traumatic brain injury, subarachnoid hemorrhage, or stroke can be challenging. Furthermore, fever may also have beneficial effects, especially in cases involving infections. While therapeutic hypothermia has shown beneficial effects in animal models, its use is still debated in clinical practice. This paper aims to describe the physiology and pathophysiology of changes in brain temperature after brain injury and to study the effects of controlling brain temperature after such injury.

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“…In this model, the elevated body temperature seen with increased ambient temperature was associated with a 100,000-fold reduction in the intraperitoneal bacterial load [19]. A recently published systematic review and meta-analysis of the effects of antipyretic medications on mortality in S. pneumoniae infection identified four animal studies comparing aspirin to placebo and demonstrated that the administration of aspirin was associated with an increased risk of death [OR 1.97 (95 %CI 1.22-3.19)] [20]. …”

Section: The Significance Of Fever In Animals With Infectionsmentioning

confidence: 99%