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Reevaluation of antipyretics in children with enteric fever
D E Noyola1, M Fernandez, S L Kaplan
1Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, USA.
Insights
Antipyretics like acetaminophen and ibuprofen did not show complications in children with enteric fever. Further research is needed to fully understand their effects in treating fever associated with this infection.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- The American Academy of Pediatrics advises against antipyretics for enteric fever due to shock risk.
- This recommendation stems from concerns about potential adverse effects of fever-reducing medications.
Purpose of the Study:
- To investigate the impact of antipyretics on blood pressure in pediatric patients diagnosed with enteric fever.
- To assess the safety and efficacy of common antipyretics in managing fever in children with enteric fever.
Main Methods:
- Retrospective analysis of medical records from Texas Children's Hospital (1977-1997).
- Inclusion criteria: patients diagnosed with enteric fever and experiencing febrile episodes.
- Evaluation focused on antipyretic use and occurrences of hypotension or cardiovascular decompensation.
Main Results:
- Twenty-nine pediatric patients with enteric fever were identified; 23 had Salmonella typhi infections.
- Antipyretics were administered to all but one patient, with no observed association with hypotension.
- One patient developed shock unrelated to antipyretics; two showed dehydration. No other complications were noted.
Conclusions:
- Acetaminophen and ibuprofen use in children with enteric fever was not associated with adverse complications in this study.
- The study suggests a need for further investigation into the role and effects of antipyretics in managing enteric fever.
Background:
The Committee on Infectious Diseases of the American Academy of Pediatrics recommends withholding antipyretic administration to patients with enteric fever because of the risk of shock developing as a consequence.
Objective:
To evaluate the effects of antipyretics on blood pressure in children with enteric fever.
Methods:
A retrospective review of medical records of patients admitted to Texas Children's Hospital from January, 1977, to October, 1997, with a diagnosis of enteric fever. All febrile episodes were evaluated for the use of antipyretics and evidence of hypotension or cardiovascular decompensation associated with them.
Results:
Twenty-nine patients with enteric fever were identified. Salmonella typhi caused 23 of these infections. Antipyretics were used in all but one patient. We did not find any association between the use of antipyretics and the development of hypotension. One patient developed shock and adult respiratory distress syndrome >36 h after start of antibiotic therapy and unrelated to fever or antipyretic use. Two patients had evidence of dehydration. No other complications occurred.
Conclusions:
We did not find any complications associated with the use of acetaminophen or ibuprofen in children with enteric fever. The effects of antipyretics in enteric fever should be further studied.