Comparison of the efficacy of paracetamol and ibuprofen for fever in children under 5 years of age

Vadim V. Abramov , Maxim L. Maximov , Boris K. Romanov , Anastasia A. Shikaleva

Russian Medicine ›› 2024, Vol. 30 ›› Issue (3) : 285 -294.

PDF
Russian Medicine ›› 2024, Vol. 30 ›› Issue (3) : 285 -294. DOI: 10.17816/medjrf627622
Reviews
review-article

Comparison of the efficacy of paracetamol and ibuprofen for fever in children under 5 years of age

Author information +
History +
PDF

Abstract

Fever accounts for a significant proportion of pediatric emergency consultations, with up to 40% of children under the age of five see a doctor for this condition. Fever is usually the result of acute respiratory viral infection, is short-lived and resolves on its own. However, in the hyperergic variant or with depletion of compensatory mechanisms, fever can be the cause of the development of pathological conditions. Therefore, timely and effective control of fever has always been a subject of interest to parents and pediatricians.

Current guidelines define fever above 38.5 °C as a condition in which the use of antipyretics is indicated. Paracetamol (acetaminophen) and ibuprofen are the most widely prescribed and available over-the-counter antipyretics in children. Despite the widespread use of these drugs, recommendations for the treatment of young children remain varied, leading to irrational use of antipyretics. Therefore, the aim of this review is to analyze existing clinical trials comparing paracetamol and ibuprofen to develop guidelines for pediatricians on the management of febrile pediatric patients.

Keywords

fever / ibuprofen / acetaminophen / antipyretics / non-steroidal anti-inflammatory agents

Cite this article

Download citation ▾
Vadim V. Abramov, Maxim L. Maximov, Boris K. Romanov, Anastasia A. Shikaleva. Comparison of the efficacy of paracetamol and ibuprofen for fever in children under 5 years of age. Russian Medicine, 2024, 30(3): 285-294 DOI:10.17816/medjrf627622

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Prado J, Daza R, Chumbes O, et al. Antipyretic efficacy and tolerability of oral ibuprofen, oral dipyrone and intramuscular dipyrone in children: a randomized controlled trial. Sao Paulo Med J. 2006;124(3):135–140. doi: 10.1590/s1516-31802006000300005

[2]

Prado J., Daza R., Chumbes O., et al. Antipyretic efficacy and tolerability of oral ibuprofen, oral dipyrone and intramuscular dipyrone in children: a randomized controlled trial // Sao Paulo Med J. 2006. Vol. 124, N 3. P. 135–140. doi: 10.1590/s1516-31802006000300005

[3]

Pitoli PJ, Duarte BK, Fragoso AA, et al. Fever in children: parents’ search for urgent and emergency services. Cienc Saude Coletiva. 2021;26(2):445–454. doi: 10.1590/1413-81232021262.40782020

[4]

Pitoli P.J., Duarte B.K., Fragoso A.A., et al. Fever in children: parents’ search for urgent and emergency services // Cien Saude Colet. 2021. Vol. 26, N 2. P. 445–454. doi: 10.1590/1413-81232021262.40782020

[5]

Meremikwu MM, Oyo-Ita A. Paracetamol versus placebo or physical methods for treating fever in children. Cochrane Database Syst Rev. 2002;2002(2):CD003676. doi: 10.1002/14651858.CD003676

[6]

Meremikwu M.M., Oyo-Ita A. Paracetamol versus placebo or physical methods for treating fever in children // Cochrane Database Syst Rev. 2002. Vol. 2002, N 2. P. CD003676. doi: 10.1002/14651858.CD003676

[7]

Wong T, Stang AS, Ganshorn H, et al. Combined and alternating paracetamol and ibuprofen therapy for febrile children. Cochrane Database Syst Rev. 2013;2013(10):CD009572. doi: 10.1002/14651858.CD009572.pub2

[8]

Wong T., Stang A.S., Ganshorn H., et al. Combined and alternating paracetamol and ibuprofen therapy for febrile children // Cochrane Database Syst Rev. 2013. Vol. 2013, N 10. P. CD009572. doi: 10.1002/14651858.CD009572.pub2

[9]

Beaudoin FL. Combination of ibuprofen and acetaminophen is no different than low-dose opioid analgesic preparations in relieving short-term acute extremity pain. BMJ Evid-Based Med. 2018;23(5):197–198. doi: 10.1136/bmjebm-2018-110912

[10]

Beaudoin F.L. Combination of ibuprofen and acetaminophen is no different than low-dose opioid analgesic preparations in relieving short-term acute extremity pain // BMJ Evid Based Med. 2018. Vol. 23, N 5. P. 197–198. doi: 10.1136/bmjebm-2018-110912

[11]

Offringa M, Newton R, Cozijnsen MA, Nevitt SJ. Prophylactic drug management for febrile seizures in children. Cochrane Database Syst Rev. 2017;2017(2):CD003031. doi: 10.1002/14651858.CD003031.pub3

[12]

Offringa M., Newton R., Cozijnsen M.A., Nevitt S.J. Prophylactic drug management for febrile seizures in children // Cochrane Database Syst Rev. 2012. N 4. P. CD003031. doi: 10.1002/14651858.CD003031.pub2

[13]

https://iris.who.int/ [Internet]. World Health Orgation. Integrated Management of Childhood Illness: distance learning course. World Health Organization; 2014. 15 p. Available from: https://iris.who.int/handle/10665/104772

[14]

https://iris.who.int/ [Internet]. World Health Orgation. Integrated Management of Childhood Illness: distance learning course. World Health Organization, 2014. 15 p. Режим доступа: https://iris.who.int/handle/10665/104772

[15]

Alaje EO, Udoh EE, Akande PA, et al. Ibuprofen versus paracetamol for treating fever in preschool children in Nigeria: a randomized clinical trial of effectiveness and safety. Pan Afr Med J. 2020;36:350. doi: 10.11604/pamj.2020.36.350.21393

[16]

Alaje E.O., Udoh E.E., Akande P.A., et al. Ibuprofen versus paracetamol for treating fever in preschool children in Nigeria: a randomized clinical trial of effectiveness and safety // Pan Afr Med J. 2020. Vol. 36. P. 350. doi: 10.11604/pamj.2020.36.350.21393

[17]

Kanabar DJ. A clinical and safety review of paracetamol and ibuprofen in children. Inflammopharmacology. 2017;25(1):1–9. doi: 10.1007/s10787-016-0302-3

[18]

Kanabar D.J. A clinical and safety review of paracetamol and ibuprofen in children // Inflammopharmacology. 2017. Vol. 25, N 1. P. 1–9. doi: 10.1007/s10787-016-0302-3

[19]

Ziesenitz VC, Welzel T, van Dyk M, et al. Efficacy and Safety of NSAIDs in infants: a comprehensive review of the literature of the past 20 years. Paediatr Drugs. 2022;24(6):603–655. doi: 10.1007/s40272-022-00514-1

[20]

Ziesenitz V.C., Welzel T., van Dyk M., et al. Efficacy and safety of NSAIDs in infants: a comprehensive review of the literature of the past 20 years // Paediatr Drugs. 2022. Vol. 24, N 6. P. 603–655. doi: 10.1007/s40272-022-00514-1

[21]

https://grls.rosminzdrav.ru/ [Internet]. State register of medicines (In Russ). Available from: https://grls.rosminzdrav.ru/

[22]

https://grls.rosminzdrav.ru [интернет]. Государственный реестр лекарственных средств. Режим доступа: https://grls.rosminzdrav.ru

[23]

Ziesenitz VC, Zutter A, Erb TO, van den Anker JN. Efficacy and safety of ibuprofen in infants aged between 3 and 6 months. Pediatr Drugs. 2017;19(4):277–290. doi: 10.1007/s40272-017-0235-3

[24]

Ziesenitz V.C., Zutter A., Erb T.O., van den Anker J.N. Efficacy and safety of ibuprofen in infants aged between 3 and 6 months // Paediatr Drugs. 2017. Vol. 19, N 4. P. 277–290. doi: 10.1007/s40272-017-0235-3

[25]

Tan E, Braithwaite I, McKinlay CJD, Dalziel SR. Comparison of acetaminophen (paracetamol) with ibuprofen for treatment of fever or pain in children younger than 2 years. JAMA Netw Open. 2020;3(10):e2022398. doi: 10.1001/jamanetworkopen.2020.22398

[26]

Tan E., Braithwaite I., McKinlay C.J.D., Dalziel S.R. Comparison of acetaminophen (paracetamol) with ibuprofen for treatment of fever or pain in children younger than 2 years // JAMA Netw Open. 2020. Vol. 3, N 10. P. e2022398. doi: 10.1001/jamanetworkopen.2020.22398

[27]

Green C, Krafft H, Guyatt G, Martin D. Symptomatic fever management in children: a systematic review of national and international guidelines. PLoS One. 2021;16(6):e0245815. doi: 10.1371/journal.pone.0245815

[28]

Green C., Krafft H., Guyatt G., Martin D. Symptomatic fever management in children: a systematic review of national and international guidelines // PLoS One. 2021. Vol. 16, N 6. P. e0245815. doi: 10.1371/journal.pone.0245815

[29]

Nourjah P, Ahmad SR, Karwoski C, Willy M. Estimates of acetaminophen (paracetomal)-associated overdoses in the United States. Pharmacoepidemiol Drug Saf. 2006;15(6):398–405. doi: 10.1002/pds.1191

[30]

Nourjah P., Ahmad S.R., Karwoski C., Willy M. Estimates of acetaminophen (paracetomal)-associated overdoses in the United States // Pharmacoepidemiol Drug Saf. 2006. Vol. 15, N 6. P. 398–405. doi: 10.1002/pds.1191

[31]

Morton SMB, Atatoa Carr PE, Grant CC, et al. Cohort profile: growing up in New Zealand. Int J Epidemiol. 2013;42(1):65–75. doi: 10.1093/ije/dyr206

[32]

Morton S.M., Atatoa Carr P.E., Grant C.C., et al. Cohort profile: growing up in New Zealand // Int J Epidemiol. 2013. Vol. 42, N 1. P. 65–75. doi: 10.1093/ije/dyr206

[33]

Bruno A, Tacconelli S, Patrignani P. Variability in the response to non-steroidal anti-inflammatory drugs: mechanisms and perspectives. Basic Clin Pharmacol Toxicol. 2014;114(1):56–63. doi: 10.1111/bcpt.12117

[34]

Bruno A., Tacconelli S., Patrignani P. Variability in the response to non-steroidal anti-inflammatory drugs: mechanisms and perspectives // Basic Clin Pharmacol Toxicol. 2014. Vol. 114, N 1. P. 56–63. doi: 10.1111/bcpt.12117

[35]

van den Anker JN. Optimising the management of fever and pain in children. Int J Clin Pract Suppl. 2013;(178):26–32. doi: 10.1111/ijcp.12056

[36]

van den Anker J.N. Optimising the management of fever and pain in children // I Int J Clin Pract Suppl. 2013. N 178. P. 26–32. doi: 10.1111/ijcp.12056

[37]

Maximov ML, Boncevich RA, Burashnikova IS, et al. Clinical pharmacology and rational pharmacotherapy for practicing physicians: a textbook. Kazan: MeDDoC; 2021. (In Russ). EDN: GBDCWZ

[38]

Максимов М.Л., Бонцевич Р.А., Бурашникова И.С., и др. Клиническая фармакология и рациональная фармакотерапия для практикующих врачей. Казань: МеДДоК, 2021. EDN: GBDCWZ

[39]

Doria M, Careddu D, Iorio R, et al. Paracetamol and Ibuprofen in the treatment of fever and acute mild–moderate pain in children: Italian Experts’ Consensus Statements. Children (Basel). 2021;8(10):873. doi: 10.3390/children8100873

[40]

Doria M., Careddu D., Iorio R., et al. Paracetamol and Ibuprofen in the treatment of fever and acute mild–moderate pain in children: Italian Experts’ Consensus Statements // Children (Basel). 2021. Vol. 8, N 10. P. 873. doi: 10.3390/children8100873

[41]

McCrae JC, Morrison EE, MacIntyre IM, et al. Long-term adverse effects of paracetamol — a review. Br J Clin Pharmacol. 2018;84(10):2218–2230. doi: 10.1111/bcp.13656

[42]

McCrae J.C., Morrison E.E., MacIntyre I.M., et al. Long-term adverse effects of paracetamol — a review // Br J Clin Pharmacol. 2018. Vol. 84, N 10. P. 2218–2230. doi: 10.1111/bcp.13656

[43]

Heubi JE, Barbacci MB, Zimmerman HJ. Therapeutic misadventures with acetaminophen: hepatoxicity after multiple doses in children. J Pediatr. 1998;132(1):22–27. doi: 10.1016/s0022-3476(98)70479-2

[44]

Heubi J.E., Barbacci M.B., Zimmerman H.J. Therapeutic misadventures with acetaminophen: hepatoxicity after multiple doses in children // J Pediatr. 1998. Vol. 132, N 1. P. 22–27. doi: 10.1016/s0022-3476(98)70479-2

[45]

Bunchorntavakul C, Reddy KR. Acetaminophen (APAP or N-Acetyl-p-Aminophenol) and acute liver failure. Clin Liver Dis. 2018;22(2):325–346. doi: 10.1016/j.cld.2018.01.007

[46]

Bunchorntavakul C., Reddy K.R. Acetaminophen (APAP or N-Acetyl-p-Aminophenol) and acute liver failure // Clin Liver Dis. 2018. Vol. 22, N 2. P. 325–346. doi: 10.1016/j.cld.2018.01.007

[47]

Tsebekova EA, Kuchaeva AV, Maksimov ML, Kiseleva NM. Pain, fever, inflammation. Clinical aspects of pharmacotherapy with non-steroidal anti-inflammatory drugs: textbook of Сlinical pharmacology. Kazan: MeDDoC; 2020. (In Russ).

[48]

Цебекова Э.А., Кучаева А.В., Максимов М.Л., Киселева Н.М. Боль, лихорадка, воспаление. Клинические аспекты фармакотерапии нестероидными противовоспалительными средствами: учебное пособие по клинической фармакологии. Казань: МеДДоК, 2020.

[49]

de Martino M, Chiarugi A, Boner A, et al. Working towards an appropriate use of ibuprofen in children: an evidence-based appraisal. Drugs. 2017;77(12):1295–1311. doi: 10.1007/s40265-017-0751-z

[50]

de Martino M., Chiarugi A., Boner A., et al. Working towards an appropriate use of ibuprofen in children: an evidence-based appraisal // Drugs. 2017. Vol. 77, N 12. P. 1295–1311. doi: 10.1007/s40265-017-0751-z

[51]

Souyri C, Olivier P, Grolleau S, et al. Severe necrotizing soft-tissue infections and nonsteroidal anti-inflammatory drugs. Clin Exp Dermatol. 2008;33(3):249–255. doi: 10.1111/j.1365-2230.2007.02652.x

[52]

Souyri C., Olivier P., Grolleau S., et al. Severe necrotizing soft-tissue infections and nonsteroidal anti-inflammatory drugs // Clin Exp Dermatol. 2008. Vol. 33, N 3. P. 249–255. doi: 10.1111/j.1365-2230.2007.02652.x

[53]

Cardile S, Martinelli M, Barabino A, et al. Italian survey on non-steroidal anti-inflammatory drugs and gastrointestinal bleeding in children. World J Gastroenterol. 2016;22(5):1877–1883. doi: 10.3748/wjg.v22.i5.1877

[54]

Cardile S., Martinelli M., Barabino A., et al. Italian survey on non-steroidal anti-inflammatory drugs and gastrointestinal bleeding in children // World J Gastroenterol. 2016. Vol. 22, N 5. P. 1877–1883. doi: 10.3748/wjg.v22.i5.1877

[55]

Balestracci A, Ezquer M, Elmo ME, et al. Ibuprofen-associated acute kidney injury in dehydrated children with acute gastroenteritis. Pediatr Nephrol Berl Ger. 2015;30(10):1873–1878. doi: 10.1007/s00467-015-3105-7

[56]

Balestracci A., Ezquer M., Elmo M.E., et al. Ibuprofen-associated acute kidney injury in dehydrated children with acute gastroenteritis // Pediatr Nephrol. 2015. Vol. 30, N 10. P. 1873–1878. doi: 10.1007/s00467-015-3105-7

[57]

Pierce CA, Voss B. Efficacy and safety of ibuprofen and acetaminophen in children and adults: a meta-analysis and qualitative review. Ann Pharmacother. 2010;44(3):489–506. doi: 10.1345/aph.1M332

[58]

Pierce C.A., Voss B. Efficacy and safety of ibuprofen and acetaminophen in children and adults: a meta-analysis and qualitative review // Ann Pharmacother. 2010. Vol. 44, N 3. P. 489–506. doi: 10.1345/aph.1M332

[59]

Lesko SM, Mitchell AA. An assessment of the safety of pediatric ibuprofen: a practitioner-based randomized clinical trial. JAMA. 1995;273(12):929–933. doi: 10.1001/jama.1995.03520360043037

[60]

Lesko S.M., Mitchell A.A. An assessment of the safety of pediatric ibuprofen: a practitioner-based randomized clinical trial // JAMA. 1995. Vol. 273, N 12. P. 929–933. doi: 10.1001/jama.1995.03520360043037

[61]

Kanabar D, Dale S, Rawat M. A review of ibuprofen and acetaminophen use in febrile children and the occurrence of asthma-related symptoms. Clin Ther. 2007;29(12):2716–2723. doi: 10.1016/j.clinthera.2007.12.021

[62]

Kanabar D., Dale S., Rawat M. A review of ibuprofen and acetaminophen use in febrile children and the occurrence of asthma-related symptoms // Clin Ther. 2007. Vol. 29, N 12. P. 2716–2723. doi: 10.1016/j.clinthera.2007.12.021

[63]

Southey ER, Soares-Weiser K, Kleijnen J. Systematic review and meta-analysis of the clinical safety and tolerability of ibuprofen compared with paracetamol in paediatric pain and fever. Curr Med Res Opin. 2009;25(9):2207–2222. doi: 10.1185/03007990903116255

[64]

Southey E.R., Soares-Weiser K., Kleijnen J. Systematic review and meta-analysis of the clinical safety and tolerability of ibuprofen compared with paracetamol in paediatric pain and fever // Curr Med Res Opin. 2009. Vol. 25, N 9. P. 2207–2222. doi: 10.1185/03007990903116255

[65]

Beasley R, Clayton T, Crane J, et al. Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6–7 years: analysis from Phase Three of the ISAAC programme. Lancet. 2008;372(9643):1039–1048. doi: 10.1016/S0140-6736(08)61445-2

[66]

Beasley R., Clayton T., Crane J., et al. Association between paracetamol use in infancy and childhood, and risk of asthma, rhinoconjunctivitis, and eczema in children aged 6–7 years: analysis from Phase Three of the ISAAC programme // Lancet. 2008. Vol. 372, N 9643. P. 1039–1048. doi: 10.1016/S0140-6736(08)61445-2

[67]

Laughey W, Lodhi I, Pennick G, et al. Ibuprofen, other NSAIDs and COVID-19: a narrative review. Inflammopharmacology. 2023;31(5):2147–2159. doi: 10.1007/s10787-023-01309-7

[68]

Laughey W., Lodhi I., Pennick G., et al. Ibuprofen, other NSAIDs and COVID-19: a narrative review // Inflammopharmacology. 2023. Vol. 31, N 5. P. 2147–2159. doi: 10.1007/s10787-023-01309-7

[69]

Hay AD, Costelloe C, Redmond NM, et al. Paracetamol plus ibuprofen for the treatment of fever in children (PITCH): randomised controlled trial. BMJ. 2008;337:a1302. Corrected and republished from: BMJ. 2009;339:b3295. doi: 10.1136/bmj.a1302

[70]

Hay A.D., Costelloe C., Redmond N.M., et al. Paracetamol plus ibuprofen for the treatment of fever in children (PITCH): randomised controlled trial // BMJ. 2008. Vol. 337. P. a1302. Corrected and republished from: BMJ. 2009. Vol. 339. P. b3295. doi: 10.1136/bmj.a1302

[71]

Wright AD, Liebelt EL. Alternating Antipyretics for fever reduction in children: an unfounded practice passed down to parents from pediatricians. Clin Pediatr (Phila). 2007;46(2):146–150. doi: 10.1177/0009922806293922

[72]

Wright A.D., Liebelt E.L. Alternating antipyretics for fever reduction in children: an unfounded practice passed down to parents from pediatricians // Clin Pediatr (Phila). 2007. Vol. 46, N 2. P. 146–150. doi: 10.1177/0009922806293922

[73]

Li SF, Lacher B, Crain EF. Acetaminophen and ibuprofen dosing by parents. Pediatr Emerg Care. 2000;16(6):394–397. doi: 10.1097/00006565-200012000-00003

[74]

Li S.F., Lacher B., Crain E.F. Acetaminophen and ibuprofen dosing by parents // Pediatr Emerg Care. 2000. Vol. 16, N 6. P. 394–397. doi: 10.1097/00006565-200012000-00003

RIGHTS & PERMISSIONS

Eco-Vector

AI Summary AI Mindmap
PDF

1373

Accesses

0

Citation

Detail

Sections
Recommended

AI思维导图

/