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Antipyretic treatment in young children with fever: acetaminophen, ibuprofen, or both alternating in a randomized,

E Michael Sarrell1, Eliahu Wielunsky, Herman Avner Cohen

  • 1Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. sarrell@netvision.net.il

Archives of Pediatrics & Adolescent Medicine
|February 8, 2006
PubMed

Insights

Alternating acetaminophen and ibuprofen is more effective for reducing fever in young children than using a single medication. This approach led to lower temperatures, faster fever reduction, and less stress and absenteeism.

Area of Science:

  • Pediatric Medicine
  • Pharmacology
  • Clinical Trials

Background:

  • Fever management in infants and young children is a common clinical challenge.
  • Acetaminophen and ibuprofen are frequently used antipyretics, but their comparative efficacy and optimal dosing strategies require further investigation.

Purpose of the Study:

  • To compare the antipyretic efficacy of acetaminophen monotherapy, ibuprofen monotherapy, and an alternating regimen of both drugs in children aged 6 to 36 months.

Main Methods:

  • A randomized, double-blind, parallel-group trial was conducted with 464 children aged 6 to 36 months presenting with fever.
  • Participants received either acetaminophen, ibuprofen, or an alternating regimen of both for three days.
  • Key outcome measures included temperature, fever recurrence, stress scores, medication usage, and absenteeism.

Main Results:

  • The alternating regimen demonstrated statistically significant improvements, including lower mean temperatures, more rapid fever reduction, and reduced medication use compared to monotherapy.
  • This group also experienced less stress and absenteeism from day care or work.
  • No significant increase in emergency department visits or serious complications was observed across any treatment group.

Conclusions:

  • An alternating treatment regimen of acetaminophen and ibuprofen every 4 hours is more effective than monotherapy for reducing fever in infants and children.
  • This strategy offers significant benefits in terms of fever control, symptom management, and reduced caregiver burden.
Abstract

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