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Acetaminophen: more harm than good for chickenpox?
T F Doran1, C De Angelis, R A Baumgardner
1Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore.
Insights
Acetaminophen (Tylenol) did not improve symptoms or shorten the duration of chickenpox (varicella) in children. In fact, it may have prolonged the illness, suggesting it is not an effective treatment for this common childhood infection.
Area of Science:
- Pediatric infectious diseases
- Pharmacology of analgesics and antipyretics
Background:
- Chickenpox (varicella) is a common viral infection in children.
- Fever and discomfort are typical symptoms of varicella.
- Acetaminophen is frequently used to manage fever and pain in children.
Purpose of the Study:
- To investigate the efficacy of acetaminophen in managing childhood varicella.
- To determine if acetaminophen influences the duration and severity of chickenpox symptoms.
Main Methods:
- A randomized, double-blind, placebo-controlled trial was conducted.
- Seventy-two children aged 1-12 years with varicella participated.
- Children received either acetaminophen (10 mg/kg/dose, 4 times daily for 4 days) or a placebo.
Main Results:
- The placebo group experienced faster total scabbing (5.6 days vs. 6.7 days) and reduced itching on day 4 compared to the acetaminophen group.
- While activity levels were slightly better in the acetaminophen group on day 2, this did not outweigh the negative effects on scabbing and itching.
- No significant differences were observed in time to last vesicle formation or overall healing time.
Conclusions:
- Acetaminophen does not appear to alleviate symptoms associated with childhood varicella.
- The use of acetaminophen may potentially prolong the duration of varicella illness.
- These findings suggest caution when using acetaminophen for symptom management in children with chickenpox.
Study Objective:
To determine whether acetaminophen affects the duration or severity of childhood varicella.
Design:
Randomized, double-blind, placebo-controlled trial.
Setting:
Office- and hospital-based pediatric practices.
Patients:
Seventy-two children between 1 and 12 years of age entered the study. One child was withdrawn because of high fever, and three children did not complete the study; 31 received placebo and 37 received acetaminophen.
Interventions:
Acetaminophen, 10 mg/kg/dose, was given at 8 AM, 12 PM, 4 PM, and 8 PM for 4 days. Placebo was given to the control group. Itching, appetite, activity, and overall condition were measured for 6 days. The time to last vesicle formation, time to total scabbing, and time to total healing were measured until complete resolution of the exanthem.
Measurements And Main Results:
The following results were better in the placebo group (p less than .05): time to total scabbing 5.6 days (SD 2.5) versus 6.7 days (SD 2.3) in the acetaminophen group, and itching on day 4 in the placebo group (symptom score 2.9 (SD 0.20) vs 2.2 (SD 0.26]. Activity was better in the acetaminophen group on day 2 (3.13 (SD 0.23) vs 2.82 (SD 0.24].
Conclusions:
These results provide evidence that acetaminophen does not alleviate symptoms in children with varicella and may prolong illness.