Antipyretic efficacy of ibuprofen vs acetaminophen

R. E. Kauffman, L. A. Sawyer and M. L. Scheinbaum
Department of Pediatrics, Wayne State University School of Medicine, Detroit, MI.

OBJECTIVE--To compare the antipyretic efficacy of ibuprofen, placebo, and acetaminophen. DESIGN--Double-dummy, double-blind, randomized, placebo-controlled trial. SETTING--Emergency department and inpatient units of a large, metropolitan, university-based, children's hospital in Michigan. PARTICIPANTS--37 otherwise healthy children aged 2 to 12 years with acute, intercurrent, febrile illness. INTERVENTIONS--Each child was randomly assigned to receive a single dose of acetaminophen (10 mg/kg), ibuprofen (7.5 or 10 mg/kg), or placebo. MEASUREMENTS/MAIN RESULTS--Oral temperature was measured before dosing, 30 minutes after dosing, and hourly thereafter for 8 hours after the dose. Patients were monitored for adverse effects during the study and 24 hours after administration of the assigned drug. All three active treatments produced significant antipyresis compared with placebo. Ibuprofen provided greater temperature decrement and longer duration of antipyresis than acetaminophen when the two drugs were administered in approximately equal doses. No adverse effects were observed in any treatment group. CONCLUSION--Ibuprofen is a potent antipyretic agent and is a safe alternative for the selected febrile child who may benefit from antipyretic medication but who either cannot take or does not achieve satisfactory antipyresis with acetaminophen.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Management following resuscitation from cardiac arrest: recommendations from the 2003 Rocky Mountain Critical Care Conference: [Conduite a tenir apres la reanimation post-arret cardiaque : recommendations de la conference du Rocky Mountain Critical Care 2003]
Bell et al.
Canadian J. Anesthesia 2005;52:309-322.
ABSTRACT | FULL TEXT  

Effect of Recent Antipyretic Use on Measured Fever in the Pediatric Emergency Department
Huang and Greenes
Arch Pediatr Adolesc Med 2004;158:972-976.
ABSTRACT | FULL TEXT  

Efficacy and Safety of Acetaminophen vs Ibuprofen for Treating Children's Pain or Fever: A Meta-analysis
Perrott et al.
Arch Pediatr Adolesc Med 2004;158:521-526.
ABSTRACT | FULL TEXT  

Antipyretic Efficacy and Safety of Ibuprofen and Acetaminophen in Children
Goldman et al.
The Annals of Pharmacotherapy 2004;38:146-150.
ABSTRACT | FULL TEXT  

Management of Fever: Making Evidence-Based Decisions
Kayman
CLIN PEDIATR 2003;42:383-392.
 

Paracetamol toxicity: epidemiology, prevention and costs to the health-care system
SHEEN et al.
QJM 2002;95:609-619.
ABSTRACT | FULL TEXT  

Acetaminophen Toxicity in Children
Committee on Drugs
Pediatrics 2001;108:1020-1024.
ABSTRACT | FULL TEXT  

Antipyretic Effects of Dipyrone Versus Ibuprofen Versus Acetaminophen in Children: Results of a Multinational, Randomized, Modified Double-Blind Study
Wong et al.
CLIN PEDIATR 2001;40:313-324.
ABSTRACT  

Alternating Antipyretics: Is This an Alternative?
Mayoral et al.
Pediatrics 2000;105:1009-1012.
ABSTRACT | FULL TEXT  

COMPARING ANTIPYRETICS IN CHILDREN
JWatch General 1992;1992:6-6.
FULL TEXT