Antipyretic drugs for children

Editor - Hay et al (1) address in their editorial on antipyretics in
children a very important topic including the lack of evidence that two
drugs are more advantageous than monotherapy and absence of evidence of
effectiveness for drug therapies compared with physical methods in
reducing fever. I disagree though with their statement that given the
desire from parents and clinicians to do something when faced with febrile
children it is churlish to withhold combined drug treatment even when
lacking evidence. Benefits of mild to moderate fever have been well
described and in a very comprehensive review Walsh and Edwards (2)
describe the lack of parents’ knowledge about normal body temperature,
correct dosage or role of antipyretics. This has resulted in a nearly
trebling of overdosing in the last 20 years and increase in unnecessary
use of healthcare services.

The results of the randomised controlled trial Hay and colleagues are
currently conducting (http://www.controlled-
trials.com/isrctn/trial/|/0/26362730.html) into drugs therapy of fever are
desperately needed but clearly, fever management is more than assessing
drug effectiveness and should include education of parents and health care
professionals about the benefits of mild to moderate fever and the role
antipyretics may play.

1 Hay et al. Antipyretic drugs for children. BMJ 2006; 333:4-5

2 Walsh A, Edwards H. Management of childhood fever by parents:
literature review.
J Adv Nurs. 2006 Apr;54(2):217-27.

Competing interests:
None declared