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Antipyretic effectiveness of acetaminophen in febrile seizures: ongoing prophylaxis versus sporadic usage
D Schnaiderman1, E Lahat, T Sheefer
1Paediatric Division, Assaf Harofeh Medical Centre, Sackler School of Medicine, Tel Aviv University, Zerifin, Israel.
Insights
Prophylactic acetaminophen does not prevent fever or reduce its severity in children with febrile seizures. Regular or sporadic dosing showed no difference in preventing recurrent seizures within 24 hours.
Area of Science:
- Pediatrics
- Pharmacology
- Neurology
Background:
- Febrile seizures are common in children.
- Acetaminophen is frequently used to manage fever associated with febrile seizures.
- The optimal dosing strategy for acetaminophen in this context is not well-established.
Purpose of the Study:
- To compare the antipyretic effectiveness of regular versus sporadic acetaminophen administration in children with febrile convulsions.
- To evaluate the impact of different acetaminophen dosing regimens on fever reduction and seizure recurrence.
Main Methods:
- A controlled clinical study involving 104 children with simple febrile convulsions.
- Group 1 received acetaminophen every 4 hours; Group 2 received it sporadically if temperature exceeded 37.9°C.
- Outcomes measured included fever incidence, temperature values, and recurrence of febrile seizures within 24 hours.
Main Results:
- No significant difference in fever incidence or temperature values between the two groups.
- Despite higher total acetaminophen dosage in the regular dosing group, antipyretic effectiveness was similar.
- Four children in each group experienced a second febrile seizure within 24 hours of admission.
Conclusions:
- Prophylactic acetaminophen administration is ineffective in preventing fever or reducing its severity in children with febrile seizures.
- Regular or sporadic acetaminophen dosing does not prevent the early recurrence of febrile seizures.
- Current prophylactic strategies for acetaminophen in febrile seizures lack demonstrated efficacy.
Abstract:
A controlled clinical study compared the antipyretic effectiveness of acetaminophen administered at regular 4h intervals (group 1, n = 53) versus sporadic usage contingent upon a body temperature above 37.9 degrees C (group 2, n = 51) in 104 children presenting with simple febrile convulsions. The incidence of febrile episodes or temperature values were similar in spite of significantly larger amounts of acetaminophen administered to patients in group 1. Four and 4 children in groups 1 and 2, respectively, had a second episode of febrile seizures, in all of them within the first 24h of admission. We conclude that the prophylactic administration of acetaminophen in children with febrile seizures is not effective in the prevention of fever, the reduction of its degree, or in preventing the early recurrence of febrile seizures.