Combining paracetamol and ibuprofen for fever in children

doi:10.1136/bmj.a1590

Published 10 September 2008, doi:10.1136/bmj.a1590
Cite this as: BMJ 2008;337:a1590

Letters

Paracetamol with ibuprofen

Combining paracetamol and ibuprofen for fever in children

The first 150 words of the full text of this article appear below.

Fever is common in childhood and associated with conditionssuch as infection. Although some infections have considerablemorbidity and mortality, fever itself is rarely dangerous. Feveris unpleasant, but how much of the child’s distress iscaused by fever, other symptoms such as pain, or parental anxietyis unclear.

Hay et al compared paracetamol and ibuprofen combinations witheither drug alone.¹ They note that treating fever with antipyreticsis not evidenced based, yet then test a potentially hazardoustreatment, when ibuprofen and paracetamol monotherapy is safeand effective.

Although combining these drugs might seem benign, encouragingpolypharmacy may lead to confusion and misdosing and the overaggressivepursuit of normothermia that many clinicians have worked hardto reduce. Even in the study, many parents dosed their childrenincorrectly. Whether combining these drugs is safe is unclear,²and could not be established in this small study.

Fever phobia among parents has been . . . [Full text of this article]

Edward Purssell, lecturer¹

¹ King’s College London, London SE1 8WA

edward.purssell@kcl.ac.uk