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Is acetaminophen or ibuprofen superior for the treatment of pediatric fever?
A meta-analysis and recent randomized controlled trial provide some guidance.
Some debate surrounds the use of antipyretics:
Adverse effects of ibuprofen compared with acetaminophen:
The appropriateness of treating pediatric fever is controversial and should be discussed with parents. If clinicians are going to recommend a treatment, they should know that ibuprofen offers superior fever reduction with no increase in adverse events.
Providing pamphlets about fever management can reduce parental anxiety and decrease emergency visits.10 Although the evidence for patient information leaflets is generally poor,11 pamphlets about pediatric infections seem to work if they are reviewed during the clinical encounter.12 Therefore, reviewing the Canadian Paediatric Society handout5 with parents to explain fever management might be helpful, but the pamphlet could be altered to encourage ibuprofen use with appropriate dosing regimens.
Tools for Practice articles in Canadian Family Physician are adapted from articles published twice monthly on the Alberta College of Family Physicians (ACFP) web-site, summarizing medical evidence with a focus on topical issues and practice-modifying information. The ACFP summaries and the series in Canadian Family Physician are coordinated by Dr G. Michael Allan, and the summaries are co-authored by at least 1 practising family physician. Feedback is welcome and can be sent to ac.cpfc@ecitcarprofsloot. Archived articles are available on the ACFP website: www.acfp.ca.
The opinions expressed in this Tools for Practice article are those of the authors and do not necessarily mirror the perspective and policy of the Alberta College of Family Physicians.