Abstract
Introduction The possibility to reduce the risk of febrile seizure (FS) recurrences with antipyretics has gained interest. To compare the antipyretic efficacy of Ibuprofen and Paracetamol in children with FS we performed a randomized, multiple dose, double blind, cross-over clinical trial. Study medication was either Ibuprofen syrup (5mg/kg per dose) or Paracetamol syrup (10mg/kg per dose) at 6 hours intervals during two days. No antibiotics were prescribed.
Participants/Measurements 70 patients with a history of FS (mean age 2.1 years) were assigned to treatment at the occurrence of a fever with rectal temperature ≥ 38.5 °C. 22 patients were included during two fevers. Temperature was recorded at 0, 2, 4, 6, 12 and 24 hours after the first dose. Temperature at 4 hours, overall mean temperature and the highest temperature during treament were evaluated. Covariance analysis corrected for base-line temperature, age, weight and clinical fever diagnosis.
Main Results Ibuprofen lowered temperature from 39.1 °C base-line to 37.7 °C overall mean, Paracetamol from 39.2 °C to 38.0 °C. Ibuprofen showed 0.50 °C more fever reduction at 4 hours after the initial dose (p=0.04). Also, overall mean temperature was 0.26 °C lower and the highest temperature was 0.30 °C lower during Ibuprofen treatment. In cross-over analysis respective differences were 0.66 °C (p=0.03), 0.40°C and 0.36 °C in favour of Ibuprofen. Two febrile seizures occurred during Ibuprofen treatment and three during Paracetamol treatment.
Conclusions Ibuprofen and Paracetamol are effective antipyretics in children with a history of FS. In the studied doses Ibuprofen reduces fever more than Paracetamol. Future clinical trials may determine the value of antipyretic treatment as a prophylaxis of recurrent febrile seizures.
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Van Esch, A., Van Steensel-Moll, H., Steyerberg, E. et al. 62 IBUPROFEN AND PARACETAMOL: EFFECTIVE ANTIPYRETICS IN CHILDREN WITH FEBRILE SEIZURES. Pediatr Res 36, 13 (1994). https://doi.org/10.1203/00006450-199407000-00062
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DOI: https://doi.org/10.1203/00006450-199407000-00062