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CHILD FEVER: PARACETAMOL OR IBUPFROFEN?

Ibuprofen was found to be more effective than paracetamol in responding quickly to a child’s fever


With fever affecting 7 out of 10 pre-school children every year, a new study into the effects of ibuprofen and paracetamol to relieve a child’s pain and temperature has caught the attention of both parents and the medical establishment alike.

“For many years, GPs have been advising parents to use a combination of paracetamol and ibuprofen for treating a child’s high fever,” writes Dr Martin Scurr, a GP, in the Daily Mail, but “this goes against the current stern warning from NICE (the National Institute for Health and Clinical Excellence) that parents should only give their children one medicine.”

However, the new study provides evidence that paracetamol and ibuprofen can be combined to reduce the time children suffer from a fever. And, what’s more, ibuprofen alone is more effective than paracetamol in responding quickly to the fever and reducing the amount of time that the fever lasts.

As the two drugs work in different ways to address illness, they are regarded as complementing each other


The study was carried out by the University of Bristol and the University of the West of England and published online in the British Medical Journal. The researchers took 156 children aged between six months and six years with temperatures between 37.8 and 41 degrees and split them into three groups. One group was given paracetamol only, one group got paracetamol plus ibuprofen but given as separate doses, and the third group was given only ibuprofen over a period of 48 hours.

The research found that ibuprofen on its own was most effective during the first four hours of a fever. Over 24 hours, children given both drugs spent 4.4 hours less time with fever than those just on paracetamol and 2.5 hours less time with fever than the children given just ibuprofen.

As the two drugs work in different ways to address illness, they are regarded as complementing each other. Whilst ibuprofen blocks the production of certain chemicals in the body which respond to injury or disease and cause inflammation, paracetamol blocks an enzyme in the brain and spinal cord that transmits pain.

The BBC quoted Dr Alastair Hay, consultant senior lecturer in primary health care who led the study: “Doctors, nurses, pharmacists and parents wanting to use medicines to treat young, unwell children should be advised to use ibuprofen first. If more sustained symptom control over a 24-hour period is wanted, giving both medicines alternately is better than giving one on its own. However, parents should keep a careful record of when doses are given to avoid accidentally giving too much.” He warned parents not to combine the doses in one solution to give to children.

Sir Muir Gray, chief knowledge officer of the NHS, notes: “This is important, but it is only a single study. We need to see how this is combined with the results of other studies.” The trial was conducted in children over six months of age and the recommendation to avoid drugs in children younger than three months still applies.

Useful links: British Medical Journal: www.bmj.com
NICE: www.nice.org.uk