Disease and Drug
<i>Ibuprofen best for child fevers</i>
Ibuprofen is better at alleviating childhood fever than paracetamol and should be the drug of first choice, say U.K. Researchers.
The Bristol-based trial involving 156 children aged between six months and six years showed ibuprofen reduced temperature faster than paracetamol.
Children were randomised to receive either paracetamol plus ibuprofen, just paracetamol, or just ibuprofen. The medicines were given over a 48-hour period, with the group of children on both paracetamol and ibuprofen receiving them as separate doses. This group received one dose of paracetamol every four to six hours (maximum of four doses in 24 hours) and then one dose of ibuprofen every six to eight hours (maximum of three doses in 24 hours).
The children's condition was followed up at 24 hours, 48 hours and at day five. The researchers found that in the first four hours children given both medicines spent 55 minutes less time with fever compared to those given paracetamol alone. But giving two medicines was not markedly better than just giving ibuprofen.
Dr Alastair Hay, consultant senior lecturer in primary health care at the University of Bristol, who led the study, said, "Doctors, nurses, pharmacists and parents wanting to use medicines to treat young, unwell children with fever should be advised to use ibuprofen first. If more sustained symptom control over a 24-hour period is wanted, giving both medicines alternately is better than giving one on its own."
In an accompanying editorial in the BMJ, Dr Anthony Harnden from the University of Oxford, warned of the relative ease with which children could receive an overdose. He said that a "more complicated alternating regimen of paracetamol and ibuprofen may be less safe than using either drug alone".
"However, this paper does demonstrate that using ibuprofen initially is more effective at reducing temperature and may demonstrate that using both ibuprofen and paracetamol together could have a positive effect."
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