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‘No evidence of harm’ from antipyretic use in feverish children

There is no evidence that antipyretics prolong fever in children with acute infections, claims a UK meta-analysis.

The study
Researchers from King’s College London looked at 110 papers comparing the use of antipyretic drugs with non-pharmacological treatments for fever in children. Five studies were included in the meta-analysis . The primary outcome was mean time to fever resolution in the antipyretic and placebo groups.

The findings
The pooled mean difference in time to fever clearance  was –4.16 hours and it was significantly faster in the children receiving antipyretic drugs compared with those who did not. The researchers examined the early and late phase of fever and determined that while antipyretic drugs should not be used early in infections, they should be considered at a later stage.

What does this mean for GPs?
The authors concluded: ‘On the basis of these studies there is no evidence that their use in children with the acute infections studied here and who are otherwise healthy will prolong the duration of fever. However, it must be stressed that this is not suggesting that they should be used, merely that there is no evidence of harm from their appropriate use based on the findings of these studies.’

J Pediatrics 2013, online 9 May

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