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Fever response to ibuprofen in viral and bacterial childhood infections
Renana Gelernter1, Nimrod Ophir2, Michael Goldman3
1Pediatric Emergency Unit, Shamir Medical Center, Zerifin 70300, Israel; The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Insights
Ibuprofen effectively reduces fever in children under 4, regardless of whether the cause is a serious bacterial infection or a viral illness. Fever response to ibuprofen does not reliably indicate serious bacterial infections in young children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Fever is a common symptom in children, often necessitating antipyretic treatment.
- Differentiating serious bacterial infections (SBI) from viral infections in febrile children is crucial for appropriate management.
- Ibuprofen is a widely used antipyretic in pediatric populations.
Purpose of the Study:
- To compare the antipyretic efficacy of ibuprofen in children with serious bacterial infections versus those with presumed viral infections.
- To determine if the fever response to ibuprofen can help differentiate between SBI and viral infections in young children.
Main Methods:
- A prospective cross-sectional study involved 90 febrile children aged 3 months to 4 years.
- Participants received 10 mg/kg of ibuprofen oral suspension, with temperature measured at 60 and 120 minutes.
- Laboratory and imaging evaluations were used to diagnose serious bacterial infections.
Main Results:
- No significant difference in temperature reduction was observed between children with SBI (n=18) and those without (n=72) at 60 and 120 minutes post-ibuprofen administration.
- Age, fever presentation, and fever duration were similar between the groups.
- Mean temperature reduction ranged from 0.89°C to 1.09°C at 60 minutes and 1.78°C to 1.85°C at 120 minutes.
Conclusions:
- The fever response to ibuprofen is not a reliable indicator for identifying serious bacterial infections in children under 4 years old.
- Further research is needed to explore the impact of ibuprofen response on managing febrile children.
Objective:
to compare the antipyretic effects of ibuprofen in febrile children with serious bacterial infections (SBI), and children with a presumed viral infection.
Methods:
A prospective cross- sectional study was conducted in a pediatric Emergency department between October 2018 and March 2020 for children aged 3 months to 4 years with a rectal temperature ≥ 38.5 °C. Patients received 10 mg/kg of ibuprofen oral suspension. Rectal temperature was measured 60 and 120 min after administration. Laboratory and imaging evaluations were performed for each study participant in order to identify serious bacterial infection.
Results:
Ninety patients were included, of which 18 were diagnosed with serious bacterial infections. There was no significant difference in age, fever at presentation and duration of fever between the groups. No significant difference was noted in body temperature reduction at 60 and 120 min after ibuprofen administration (1.09 ± 0.75 °C vs 0.89 ± 0.58 °C, mean difference -0.12 °C, 95% CI -0.54-0.15 °C; 1.85 ± 0.53 °C vs 1.78 ± 0.83 °C, mean difference - 0.07 °C, 95% CI -0.49-0.36 °C, in the SBI and non-SBI groups respectively).
Conclusion:
Fever response to Ibuprofen administration is not indicative of serious bacterial infections in children under 4 years of age. Larger prospective studies are required to define whether the lack of response to Ibuprofen has any impact on the management of febrile children.
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