The management of fever in children

Fever is an abnormal increase in body temperature that occurs as part of a specific biologic response mediated and controlled by the central nervous system. Despite the fact that most fevers are viral in origin, approaching a febrile child is always a concern for any physician. There is still a significant gap between current practice and scientific evidence. According to research, we are at a crossroad, with strong research evidence accumulating over the last few decades supporting a positive role for fever and the ongoing pressures of current practice to lower body temperature. Despite the fact that most pediatricians agree that treating a febrile child with antipyretics is primarily for the relief of fever symptoms, many continue to prescribe antipyretics for any child with fever, ignoring important research messages. By prescribing antipyretics to children who are only mildly febrile, pediatricians may contribute to fever phobia. We give parents the impression that fever is harmful and that antipyresis is beneficial when we focus on treating the fever. The purpose of this review is to present the evidence that is currently available regarding the management of the febrile child.