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Comparative evaluation of the antipyretic efficacy of ibuprofen and paracetamol
Y M Joshi1, V B Sovani, V V Joshi
1Medical Research Division, Cipla Limited, Bombay Central.
Insights
Ibuprofen and paracetamol show comparable fever-reducing effects in children. Ibuprofen (7 mg/kg) is a viable alternative antipyretic, though further trials with higher doses are recommended.
Area of Science:
- Pediatrics
- Pharmacology
- Clinical Medicine
Background:
- Fever is a common symptom in children, necessitating effective antipyretic treatments.
- Ibuprofen and paracetamol are widely used antipyretics, but direct comparative efficacy data in pediatric populations can be limited.
Purpose of the Study:
- To compare the antipyretic efficacy of ibuprofen (7 mg/kg) and paracetamol (8 mg/kg) in children.
- To evaluate ibuprofen as a potential alternative antipyretic agent in pediatric clinical practice.
Main Methods:
- An open, multicenter trial involving 175 febrile children aged 4 months to 12 years.
- Patients were randomized into two groups: ibuprofen (n=85) and paracetamol (n=90).
- Axillary temperatures were recorded every 30 minutes for 2 hours post-administration.
Main Results:
- While overall temperature reduction at 1, 1.5, and 2 hours was similar and not statistically significant, a statistically significant difference was observed at 30 minutes.
- At 30 minutes, paracetamol showed a greater mean temperature fall (0.3843 ± 0.0490 °C) compared to ibuprofen (0.1975 ± 0.0409 °C), a difference of 0.19 °C (p < 0.05).
- Despite the initial difference, both drugs demonstrated comparable overall antipyretic activity over the 2-hour period.
Conclusions:
- Ibuprofen (7 mg/kg) exhibits antipyretic efficacy comparable to paracetamol (8 mg/kg) in children.
- Ibuprofen presents a valuable alternative antipyretic option for pediatric use.
- Further research with higher ibuprofen dosages is warranted to establish dose-response relationships and identify optimal dosing.
Abstract:
An open multicentric trial was conducted on 175 patients to compare the antipyretic efficacy of ibuprofen (7 mg/kg) and paracetamol (8 mg/kg). Children between the age of 4 months and 12 years with fever were admitted to the study, 85 in the ibuprofen group and 90 in the paracetamol group. The axillary temperatures were recorded at half hourly intervals for 2 hours. The mean fall in temperature at 1, 1.5 and 2 hours was similar in both groups and the differences were not statistically significant (p greater than 0.05). At half hour, the fall in temperature (mean +/- SEM) for ibuprofen was 0.1975 +/- 0.0409 and for paracetamol was 0.3843 +/- 0.0490. This absolute difference of 0.19 degrees C was statistically significant (p less than 0.05). We conclude that ibuprofen has antipyretic activity comparable to that of paracetamol and that it could be a valuable alternative antipyretic in clinical practice. There is a need to repeat this trial with higher doses of ibuprofen, to establish a dose response of the drug, if any, and to find an optimally effective dose.