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Fever in children: paracetamol is the best treatment to relieve the symptoms

When medication is required to reduce fever in children, paracetamol alone is the best choice.

When a child runs a fever and medication is necessary to relieve the symptoms, paracetamol is the best treatment, even if it is not fully effective. Other antipyretic drugs are sometimes used, including ibuprofen, a nonsteroidal anti-inflammatory drug whose adverse effects can sometimes be serious (risk of infection in particular).

A trial evaluated the benefits of combining ibuprofen and paracetamol to reduce fever in children. The trial included 156 children aged between 6 months and 6 years treated with paracetamol alone, ibuprofen alone, or a combination of paracetamol + ibuprofen.

During the first 4 hours, the children treated with the combination remained fever-free for longer, 171 minutes, compared with 156 minutes with ibuprofen and 116 minutes with paracetamol alone, with no improvement of the symptoms associated with fever. But after 48 hours, no difference in the symptoms associated with fever was observed between the groups.

In short, ibuprofen, used alone or in combination with paracetamol, lowers the fever for only a few more minutes at the start of treatment but exposes patients to sometimes severe adverse effects. When a child presents a fever and medication is necessary to reduce symptoms, it is better to keep to paracetamol.

©Prescrire August 2009

Source: "Fièvre des enfants : en rester au paracétamol" Rev Prescrire 2009; 29 (309): 526.

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