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Risks of antipyretics in young children with fever due to infectious disease
T Sugimura1, T Fujimoto, H Motoyama
1Department of Pediatrics, Fujimoto Children's Hospital, Oita, Japan.
Insights
Frequent paracetamol (acetaminophen) use in children with bacterial infections may worsen illness. Children who developed pneumonia received more daily doses than those who did not.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Fever is a common symptom in children with bacterial infections.
- The role of antipyretics like paracetamol (acetaminophen) in modulating the course of pediatric infectious diseases is not fully understood.
- Understanding the impact of fever management on illness outcomes is crucial for clinical practice.
Purpose of the Study:
- To investigate the association between paracetamol (acetaminophen) administration and the clinical outcome of children with fever due to bacterial infection.
- To determine if the frequency of paracetamol (acetaminophen) use influences the progression of illness, specifically the development of pneumonia.
- To compare paracetamol (acetaminophen) dosage patterns in children who developed pneumonia versus those who did not.
Main Methods:
- A cohort of 208 outpatients (6 months to 15 years) with fever from bacterial infection was studied.
- Patients were divided into a pneumonia group (n=101) and a control group (n=107) who did not develop pneumonia.
- The daily number of paracetamol (acetaminophen) doses (10 mg/kg) administered within the first 3 days of acute fever was recorded and compared between groups.
Main Results:
- The pneumonia group received a significantly higher mean number of daily paracetamol (acetaminophen) doses (2.52) compared to the control group (1.37) (P < 0.001).
- No significant difference in peak body temperature during acute fever was observed between the pneumonia and control groups.
- These findings suggest a potential link between frequent antipyretic use and more severe illness progression.
Conclusions:
- Frequent administration of paracetamol (acetaminophen) in children with bacterial infections may be associated with a worsening of their illness.
- The study highlights the need for further research into the effects of antipyretics on the natural course of pediatric infectious diseases.
- Clinical guidelines for fever management in children with bacterial infections may need to consider the potential impact of frequent antipyretic use on outcomes.
Abstract:
The objective of this study was to determine whether paracetamol (acetaminophen) affects the outcome of children with fever due to bacterial infectious disease. A total of 208 outpatients aged 6 months to 15 years with pyrexia due to bacterial infection who had been examined at the Fujimoto Children's Hospital from March 1992 to May 1992. The number of antipyretic doses of paracetamol (10 mg/kg) a day received within 3 days of illness in the patients with acute fever (> or = 38 degrees C) was investigated. In this study, the patients were divided into two groups: (i) the pneumonia group, which consisted of 101 patients who were subsequently diagnosed as having pneumonia during their illness and (ii) the control group, which consisted of 107 patients who were subsequently diagnosed as having illness with fever that did not progress to pneumonia. The mean number of daily doses was significantly higher for the pneumonia group (2.52 +/- 0.80) than for the control group (1.37 +/- 0.72, P < 0.001). There was no significant difference between the pneumonia group and the control group in body temperature during acute fever (38.7 +/- 0.65 vs 38.8 +/- 0.54 degrees C). The data suggest that frequent administration of antipyretics to children with infectious disease may lead to a worsening of their illness.