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The Honolulu Advertiser
Posted on: Thursday, September 4, 2008

Alternating drugs reduces fever longer

HealthDay

Fever in young children can be reduced for a longer period of time by giving them ibuprofen first, followed by acetaminophen plus ibuprofen, according to British researchers. Acetaminophen is called paracetamol in Britain.

The study included 156 children, ages 6 months to 6 years, that had a temperature of between 100.04 F to 105.8 F due to an illness that could be managed at home. The children were randomly selected to receive either acetaminophen plus ibuprofen, just acetaminophen, or just ibuprofen.

The children's parents were instructed to give the medicines for up to 48 hours — acetaminophen every four to six hours (maximum of four doses in 24 hours) and ibuprofen every six to eight hours (maximum of three doses in 24 hours).

The researchers assessed the children's condition after 24 hours, 48 hours and five days. They found that in the first four hours, children given both medicines spent an extra 55 minutes less time with fever compared with those given paracetamol alone. But giving two medicines was not markedly better than just giving ibuprofen.

After 24 hours, children given both medicines experienced 4.4 hours less time with fever than those that received just acetaminophen, and 2.5 hours less time with fever than children that received just ibuprofen.

"Doctors, nurses, pharmacists and parents wanting to use medicines to treat young, unwell children with fever should be advised to use ibuprofen first and to consider the relative benefits and risks of using both medicines over a 24-hour period," wrote the researchers, from the University of Bristol and the University of the West of England.

The study was published online Sept. 3 by the British Medical Journal. This study showed that longer-action ibuprofen was the most suitable medicine to use for fever in children, Dr. Anthony Harnden, of the University of Oxford, wrote in an accompanying editorial.

The fact that 31 children in this study received an overdose shows that it's easy for parents to overdose their children, which means that a "more complicated alternating regimen of paracetamol and ibuprofen may be less safe than using either drug alone."