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Antipyretic Efficacy of Ibuprofen and Acetaminophen in Children With Febrile Seizures
Adrianus Van Esch, MD;
Henriétte A. Van Steensel-Moll, MD, PhD;
Ewout W. Steyerberg, MSc;
Martin Offringa, MD;
J. Dik F. Habbema, PhD;
Gerarda Derksen-Lubsen, MD, PhD
Arch Pediatr Adolesc Med. 1995;149(6):632-637.
Abstract
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Objective
To compare the antipyretic efficacy of ibuprofen syrup (5 mg/kg per dose) and acetaminophen syrup (10 mg/kg per dose) in children with a history of febrile seizures.
Design
Randomized, multiple-dose, double-blind, cross-over trial.
Setting
The outpatient department of a universityaffiliated teaching hospital.
Patients
Seventy outpatients (mean age, 2.1 years; range, 10 months to 4 years) who had visited the hospital because of a febrile seizure were randomized to treatment at a temperature of 38.5°C or higher.
Interventions
Study medication was given every 6 hours for 1 to 3 days. Rectal temperatures were recorded at 0, 2, 4, 6, 12, and 24 hours after the first dose.
Main Outcome Measures
The temperature 4 hours after the first dose, the mean temperature during treatment, and the highest temperature during treatment were evaluated. Analysis of covariance corrected for the initial temperature, age, weight, and cause of the fever.
Results
Ibuprofen lowered the initial temperature from 39.1°C to a mean temperature of 37.7°C during treatment; acetaminophen lowered the initial temperature from 39.2°C to 38.0°C. Ibuprofen reduced fever 0.50°C more than did acetaminophen at 4 hours (95% confidence interval [CI],—0.98 to—0.02). The mean temperature was 0.26°C lower during ibuprofen treatment (95% CI,—0.59 to 0.07); the highest temperature was 0.30°C lower (95% CI,—0.73 to 0.13). In 22 patients, a second fever was treated with the opposite medication than the first. In the crossover analysis, the respective differences were 0.66°C (95% CI,—1.29 to—0.06), 0.40°C(95% CI—0.83 to 0.03), and 0.36°C (95% CI,—0.81 to 0.08) in favor of ibuprofen.
Conclusions
Ibuprofen and acetaminophen are effective antipyretic agents in children with a history of febrile seizures. Ibuprofen yielded significantly greater fever reduction than did acetaminophen 4 hours after the first dose. Research is needed on the value of antipyretic agents for the prevention of febrile seizure recurrence.
(Arch Pediatr Adolesc Med. 1995;149:632-637)
Author Affiliations
From the Departments of Pediatrics, University Hospital Rotterdam (the Netherlands), Sophia Children's Hospital (Drs Van Esch, Van Steensel-Moll, Offringa, and Derksen-Lubsen), and the Center for Clinical Decision Sciences, Department of Public Health, Erasmus University, Rotterdam (Drs Van Esch and Offringa and Messrs Habbema and Steyerberg).
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